The purpose of physical therapy after breast radiation is to prevent chronic pain, restore or maintain optimal function and improve quality of life.

Patients who are treated with radiation for breast cancer deal with extensive side-effects including physical, emotional issues and functional limitations during and even many years after treatment.

What are the short-term side effects of breast radiation for breast cancer?

Short-side effects of radiation start within a few weeks after the first treatment. Short-side effects include:

Skin changes

  • Itching.
  • Redness.
  • Blistering.

Fatigue and Tiredness

Fatigue is a persistent feeling of physical and emotional tiredness that is not related to physical activity or exertion, instead related to cancer treatments.  Breast radiation causes acute fatigue in 80% of cases according to recent studies.


  • Sharp shooting pain in neck, shoulder and breast area.
  • Muscle twitching.


Feeling sick during the treatment.

  • Short-side effects will usually subside during the following weeks.

What are the long-term side effects of breast radiation for breast cancer?

Long-term side effects appear a few months to years after radiation. Long-term side effects include:

Changes in the breast area

  • Breast shrinks.
  • Breast gets firmer to the touch.
  • Skin color changes.
  • Swollen breast.
  • Tenderness.
  • Pain, discomfort.


It is the accumulation of excess fluids around the armpit, chest, and arm due to compression of the lymphatic channel from lymph nodes removal or/and radiation.


Scar tissue that appears after a surgery or breast radiation to the armpit.


  • Pain.
  • Numbness and tingling of the arm.


Intermittent pain in the breast area, armpit and neck. Chronic pain can last months or years after treatments.

Breast, shoulder and armpit issues

  • Arm weakness.
  • Pain.
  • Lymphedema.
  • Shoulder stiffness.
  • Neck stiffness.
  • Decreased strength.
  • Poor posture.
  • Phantom breast pain.

Shoulder weakness and shoulder stiffness may persist for many years after breast radiation. 

Less common long-term side effects

  • » Widen blood vessels

Very notorious widen blood vessels on the skin that got radiation.

  • » Lung fibrosis

Radiation can produce scars of the lungs tissues.

  • » Frail bones

Breast radiation makes ribs bone frail.

  • » Weak heart

Radiation on the left breast may injure a small area of the heart predisposing it to heart issues.

  • » Nerve damage

Damage in the nerves that are localized near the armpit causing numbness, tingling and weakness of the hand and arm.

  • » Shoulder tendinitis
  • » Neck pain and stiffness 
  • » Cervical radiculopathy

How physical therapy alleviates breast radiation side-effects?

Physical therapy reduces pain without medication, prevents shoulder stiffness, prevents scar adhesion, decreases fatigue, improves strength, and improves quality of life after breast radiation.

First two weeks

  • Gentle arm exercises below 90 degrees of arm elevation.
  • Manual therapy to decrease pain.
  • Posture correction exercises to prevent body compensations and misalignments.
  • Education on gentle massage to the affected area.

Between two to four weeks

  • Manual therapy to prevent tissue adhesion and pain management.
  • Gentle arm exercises above 90 degrees.
  • Gentle stretches as tolerated.

One to three months after radiation

  • Guided Shoulder stabilization exercises.
  • Trunk control/core strengthening.

After three months

Customized exercise program to meet patients needs and improve quality of life.

Physical therapy can help with:

  • Self-care.
  • Energy conservation techniques.
  • Range of motion exercises.
  • Strengthening exercises.
  • Exercises to preserve bone mineral density.
  • Breathing techniques to manage stress and anxiety.
  • Posture reeducation.

Emotional issues side-effects

  • Fatigue.
  • Anxiety.
  • Stress.
  • Depression.
  • Sleep disorder.
  • Fear of recurrence.


  • Pain.
  • Treatment side effects.
  • Early menopause.
  • Personal concern (self-image).
  • Inability to go back to work, take care of her family, family concerns, marital issues.

Tips to manage emotional issues

Guided exercises

Exercise is the most effective approach to manage emotional issues, especially fatigue, according to the National Comprehensive Cancer Center (NCCN).

Gentle yoga and mindfulness meditation 

Calm the mind and relax and stretch the body.

Improve physical and emotional wellbeing

Click Here for tips to manage emotional issues.

Click Here for more tips to manage side-effects after breast cancer radiation from the Breast Cancer Organization.

If you are dealing with pain, shoulder stiffness, tiredness, and arm weakness after breast radiation call now to find out how Physical Therapy can help you recover faster, move easier, and freer:

Call Dr. Alexandra Chaux:  805-203-9940

The information in this blog is for educational and informational purpose only, its content is provided based upon evidence-based physical therapy research, knowledge, and experience as a Doctor of Physical Therapy (DPT).