Breast size: How large breasts cause Musculoskeletal pain

Breast Size Varies throughout Life

Breast size and mass vary throughout life, influenced by hormonal changes, body fat composition, stage of reproductive cycle, and breast pathology. Bra size, when fitted according to defined industry standards, may be used as an estimate of breast size. Across the lifespan and across the population, bra size is not a consistent measure of breast mass which is most accurately estimated from radiographic measures of volumetric density, but among healthy women who have never been pregnant or experienced breast pathology, bra size is likely to be a consistent measure (Wood et al. 2008).

Large Breasts (Macromastia) and Musculoskeletal Pain

Back pain, including thoracic spinal pain, is a common, potentially disabling, routine presenting complaint to general practitioners [1]. Macromastia is the state of having disproportionately large breasts. Some macromastic women report breast pain and other symptoms, and the intuitively logical assumption is that breast size is the key influence on clinical presentation. Clinical symptoms attributed to macromastia include neck, thoracic spine and shoulder pain, breast pain, headaches, grooving and associated pain caused by bra straps, intertrigo (inflammation of skinfolds), and ulnar nerve paresthesia (Wood et al. 2008).

Pain is more likely to affect women with breast size D or bigger. As the large breast sizes were found to affect the mechanics of the spine, both the thoracic kyphosis and the lumbar lordosis angle were higher in women with bra size D than in women with bra size A, B, or C.This is because  women with macromastia adopt a corrective posture due to the effect of the breasts on their center of gravity and possibly in a subconscious effort to conceal their breasts (Lapid et al. 2013).

Breast Related Thoracic (Mid-Back) Pain

Breast-related thoracic spinal pain is thought to result from changes in centre of gravity as that static spinal posture differs significantly according to breast size. Large breasts can increase cervical lordosis and thoracic kyphosis, shift the centre of gravity away from the spine and increase muscular effort required to maintain balance. They also suggested that large or heavy breasts may also lead to continuous tension on the middle and lower fibres of the trapezius muscle and associated muscle groups (Wood et al. 2008).

Having large breast size may place addition weight through your spinal column predisposing you to mechanical back pain.  As Foreman et al. (2009) hypothesized that mammaplasty surgery would result in reductions in low-back compressive forces in women with macromastia.

Large Breasts can cause Headaches

Having large breasts can cause headaches. As it found that  patients with macromastia who have occipital neuralgia and/or chronic headaches/migraines can experience headache relief following reduction mammaplasty (Ivica and Matthew,  2010).

Osteopathic Treatment

Osteopathic treatment is a manual therapy approach to treating neck pain, shoulder and back pain. Treatment also focuses on addressing my postural complaints and lifestyle issues.

To make an appointment with an osteopath at Cam Osteopathy click on book an appointment

If osteopathic treatment is unable to reduce the pain associated with back, shoulder and neck, then a referral to a plastic surgeon maybe required for breast reduction surgery.

Breast Reduction Surgery

Some women with macromastia (large breasts) have to undergo a breast reduction due to back pain (92%), painful bra grooving (94%), neck pain (95%), and shoulder pain (94%). Bra grooving and back, neck, and shoulder pain significantly decrease or totally disappear after reduction mammaplasty.

Reference List

Ivica D and Matthew L (2010). Chronic Headaches/Migraines: Extending Indications for Breast Reduction. Plastic & Reconstructive Surgery: January 2010 – Volume 125 – Issue 1 – pp 44-49

Foreman KB1, Dibble LE, Droge J, Carson R, Rockwell WB (2009). The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia. Plast Reconstr Surg. Nov;124(5):1393-9

Lapid O, de Groof EJ, Corion LU, Smeulders MJ, van der Horst CM (2013). The effect of breast hypertrophy on patient posture. Arch Plast Surg. Sep;40(5):559-63.

Wood K, Cameron M, Fitzgerald K (2008). Breast size, bra fit and thoracic pain in young women: a correlational studyChiropr Osteopat.  Mar 13;16:1

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