Joint pain related to hormone-blocking treatments

Joint pain can be a side effect of any breast cancer treatment that causes menopausal symptoms.

It’s common for hormone-blocking therapy to cause aching or pain in the joints and muscles. This is often referred to as AIMSS (aromatase inhibitor musculoskeletal syndrome). The therapies that can cause this include the aromatase inhibitors anastrazole, letrozole and exemestane.

Often the pain is mild and temporary but for some may be more severe and long-lasting.

It is important to talk to your treating team about any pain you may be experiencing.

Exercise and activity

Joint pain or stiffness is usually worse in the morning and improves as you move around.

Exercise and keeping active can help reduce discomfort.
There are many options for you to try.

• Walking and other weight-bearing exercises help keep you flexible. They strengthen your muscles to help protect the joints in your legs.
• Gentle exercise and stretching such as tai chi and yoga can help reduce joint pain
• Lifting light weights that strengthen muscles can also be helpful.

People often report that pool-based activities such as swimming and hydrotherapy (exercise in a heated pool) help.
Speak with your treatment team about which exercises are safe for you. They may refer you to an Accredited Exercise Physiologist (AEP) or physiotherapist.

Ask your GP about a Chronic Disease Management Plan, which gives you a limited number of Medicare-subsidised visits to an exercise physiologist or physiotherapist.

Your treating hospital or health service may also run exercise programs you can access.

Find exercise programs near you in BCNA’s Service Finder.

Over-the-counter pain relief

Paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as Nurofen or Voltaren may provide relief.

Before taking any over-the-counter medication, check the best option with your doctor. They can tell you the correct dose, side effects and how long to take it for.

If you’re having chemotherapy, speak with your medical oncologist or oncology nurse before taking medication. If the pain relief contains ibuprofen (such as Nurofen) or other anti-inflammatory medications, they need to check it’s safe for you.

Other medications

Sometimes switching from one AI to another can help reduce side effects such as AIMSS. While all therapies work, everybody is different and sometimes people tolerate one drug more than another. Always check with your doctor or nurse to understand the options.

The drug duloxetine (Cymbalta) has shown to be very good for joint pain and muscle stiffness. Your oncologist may prescribe this if other non-medical treatments are not easing your symptoms.

Complementary medicines

Some complementary treatments are shown to reduce joint pain in some people, such as:

• acupuncture
• gentle heat using a wheat bag or heat pack.

Always speak with your medical oncologist or oncology nurse if you are considering any complementary or alternative treatments. It’s important to check they won’t interfere with your breast cancer treatment.

In clinical trials, alternative therapies such as glucosamine and fish oil have shown they are no better than the placebo used during the trial.

Trials are in progress to see whether curcumin may be of benefit.

Read about Complementary medicines.