Axillary Web Syndrome (AWS): What You Need to Know

February 4, 2025 / Cancer Rehab
Axillary Web Syndrome (AWS): What You Need to Know

Axillary Web Syndrome (AWS) is a condition that often affects individuals who have undergone breast cancer treatments, particularly those who have had axillary lymph node dissection (ALND) or radiation therapy. This condition, also known as “cording,” involves the development of tight bands or cords of tissue in the armpit area, which can extend down the arm, causing pain and restricting movement. Though it is a common aftereffect of breast cancer treatment, AWS is not always well understood. In this blog, we’ll explore what AWS is, its symptoms, how it affects daily life, and how physiotherapy can help manage the condition.

If you have more questions about Axillary Web Syndrome, the cancer rehab physiotherapists at Triangle Physiotherapy would be more than happy to help you out.

What is Axillary Web Syndrome?

AWS occurs when tight bands of tissue, or “cords,” form under the skin in the armpit (axilla) and sometimes along the upper arm. These bands are typically made of scar tissue or fibrosis that develops after the removal of lymph nodes or following radiation therapy, both of which are common treatments for breast cancer. These tight bands can cause significant discomfort, limit the range of motion, and affect daily activities, such as reaching, lifting, or even carrying objects.

Axillary Web Syndrome

Picture Credit: healthline.com

AWS is usually diagnosed when the cords are palpated (felt) by a healthcare professional during a physical exam. In some cases, individuals may notice the bands themselves or feel a pulling sensation in the arm or chest.

Symptoms of AWS

The most noticeable symptom of AWS is the formation of tight, rope-like cords in the armpit area, but other symptoms may include:

  • Pain: The cords can be painful to the touch and can cause discomfort during everyday activities.
  • Restricted Mobility: Individuals with AWS often experience limited range of motion in the shoulder and arm, particularly when reaching overhead or behind.
  • Tightness: A sensation of tightness or pulling in the chest, armpit, and down the arm is common.
  • Swelling: Some people may also experience swelling in the arm or hand due to lymphatic fluid build-up, especially if there has been lymph node removal.

These symptoms can make simple tasks, like putting on a shirt, lifting objects, or even driving, much more difficult. For many people, AWS can impact their emotional well-being as well, as chronic pain and restricted mobility can be frustrating and limiting.

How Does AWS Affect Daily Life?

The symptoms of AWS can significantly affect an individual’s daily life. Limited shoulder and arm mobility can interfere with work, hobbies, and social activities. Pain and tightness may make it hard to perform basic activities, like reaching for items on a high shelf, carrying groceries, or participating in exercise. As a result, people with AWS may become less active, which can lead to muscle weakness, poor posture, and a reduced quality of life.

Additionally, AWS can lead to long-term issues, such as decreased self-esteem and increased stress, as individuals cope with their physical limitations. It’s important for people with AWS to seek support and find ways to manage the condition so that they can maintain a high quality of life during their recovery journey.

How Physiotherapy Can Help

Physiotherapy is one of the most effective treatments for managing AWS. A physiotherapist can develop a personalized rehabilitation program to help manage pain, improve mobility, and reduce the tightness associated with the condition. Common physiotherapy treatments for AWS include:

  • Manual Therapy: Techniques like massage or myofascial release can help release tension in the affected tissues, reducing pain and increasing flexibility.
  • Stretching and Mobility Exercises: Physiotherapists will guide patients through stretching exercises to improve the range of motion in the shoulder and arm. This can help reduce tightness and discomfort, allowing for greater movement.
  • Strengthening Exercises: Strengthening the muscles around the shoulder and upper arm is essential for improving function and reducing strain. Physiotherapists can design specific exercises to help restore muscle strength and support the joint.
  • Scar Tissue Management: Physiotherapists can use specific techniques to address scar tissue buildup that can contribute to AWS, helping to soften and break down fibrous tissue, improving movement and reducing pain.

Axillary Web Syndrome is a condition that can develop after breast cancer treatments and cause pain, tightness, and limited mobility. While it can be frustrating and limiting, it’s important to know that physiotherapy can be an effective way to manage the symptoms and improve quality of life. By working with a physiotherapist, individuals with AWS can regain movement, reduce discomfort, and take steps toward better overall health and well-being. If you or someone you know is experiencing symptoms of AWS, don’t hesitate to seek help and explore the benefits of physiotherapy for relief. Our Cancer Rehab Physiotherapists at Triangle Physiotherapy have training in helping individuals who have had cancer treatments to improve their quality of life.