Joint and muscle pain from hormone therapy for breast cancer
Hormonal therapy for breast cancer can sometimes cause pain in the joints and muscles. Joint pain is also a common symptom of the menopause.
Pain in the joints (arthralgia)
You may get joint pain and sometimes muscle pain if you:
- take an aromatase inhibitor (AI) (such as anastrozole, letrozole and exemestane)
- are having, or have had, ovarian suppression (drugs to stop the ovaries working or surgery to remove the ovaries).
Joint pain is probably caused by a decrease in oestrogen levels. It is also a common symptom of the menopause.
Pain is most common in the hands and feet, but can also happen in the knees, hips, lower back and shoulders. You may have it all the time or it may come and go. You may notice that your joints are stiffer in the morning, when you first get up.
If you have recently started taking an aromatase inhibitor, the pain may get better over the next few months. This may happen as the body adjusts to changes in hormone levels. Aromatase inhibitors are very good at reducing the risk of breast cancer coming back.
You should not stop taking your treatment without talking to your cancer doctor. There is usually something that can be done to improve pain.
Related pages
Treatment for joint pain and muscle pain
Doctors can prescribe different painkillers for joint and muscle pain. These include:
- simple painkillers, such as paracetamol
- anti-inflammatory painkillers, such as ibuprofen.
If the pain is difficult to cope with, your cancer doctor may suggest changing the type of aromatase inhibitor you take. If that does not work, they may suggest you take tamoxifen instead. Tamoxifen causes fewer problems with joint pain.
Some studies suggest that if you have lower levels of vitamin D, taking vitamin D3 supplements may improve symptoms. Talk to your doctor before taking a supplement.
What you can do about joint problems
Talk to your doctor
It is important to talk to your cancer doctor or specialist nurse if joint or muscle pain is a problem for you. Your doctor can prescribe drugs to help control the symptoms and find other ways of improving them.
See a physiotherapist
If you are having lots of problems with pain, your cancer doctor can refer you to a physiotherapist. They can give you more advice and treatment.
See an occupational therapist
If you are having difficulty doing daily tasks, you can also ask to be referred to an occupational therapist (OT). They will be able to assess your needs and suggest aids and equipment to help you.
Keep active
Try doing regular exercise to strengthen the muscles around your joints. This can help to keep them flexible and reduce pain. Some types of exercise may feel more comfortable than others. These include non-weight-bearing exercises, such as swimming and cycling.
Ask your doctor about complementary therapies
Acupuncture may help to reduce pain from joint symptoms. Some local charities may offer free acupuncture. Sometimes it may be available on the NHS, but this is not common. The needles should not be used on the arm of the affected side.
Complementary therapies such as massage may be helpful for some people. Some hospitals offer massage on the NHS.
It is very important to talk to your cancer doctor or specialist nurse before starting complementary therapies. They can talk to you about any possible harmful impacts these could have on your cancer treatment, and about any possible side effects.
About our information
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References
Below is a sample of the sources used in our late effects of breast cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Curigliano et al 2020. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Annals of Oncology. Vol 31 (2). Available from: www.annalsofoncology.org/article/S0923-7534(19)36080-6/pdf [accessed November 2021].
Fabi et al 2020. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology. Available from: www.annalsofoncology.org/article/S0923-7534(20)36077-4/pdf [accessed November 2021].
National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. NG101. Available from: www.nice.org.uk/guidance/ng101 [accessed November 2021].
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Rebecca Roylance, Consultant Medical Oncologist and Professor Mike Dixon, Professor of Surgery and Consultant Breast Surgeon.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
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