Myofascial Release or Trigger Point Injections for the Reduction of Post-Mastectomy Pain Syndrome

PRIMARY OBJECTIVE: I. To evaluate the change in pain score using the Numerical Rating Scale for pain on an 11-point scale (0-none to 10-worst) from implementation of myofascial release (MFR) versus trigger point injections (TPI) in the treatment of myofascial trigger points (MTP) as noninvasive therapies for post mastectomy pain syndrome (PMPS). SECONDARY OBJECTIVES: I. To evaluate the change in medications, particularly opiate medications in the treatment of post mastectomy pain. II. To evaluate a patient's satisfaction with therapy or treatment throughout the course of the study at each consecutive encounter or follow up. III. To evaluate a patient's range of motion with therapy or treatment beginning at time of screening and until the end of the study. IV. To evaluate a patient's degree of lymphedema both subjectively and objectively in the affected extremity(ies) unilateral to the site(s) of mastectomy in response to the various forms of treatment throughout the study. V. To evaluate quality of life measure changes with treatments used throughout the study. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive standard of care trigger point injections at baseline. ARM II: Patients perform myofascial release for 10 minutes each day.