Back Pain From Breasts: How to Get Relief

Key takeaways:

• Large breasts (macromastia) can cause back pain and other symptoms.
• At-home measures like taking over-the-counter pain relievers, using hot compresses, or getting a massage can help you find relief.
• There are other options for those with severe back pain from breasts, including surgical breast reduction (reduction mammoplasty.)

Macromastia is the medical term for large breasts. Large breasts can cause back, neck, and shoulder pain. Mild symptoms can usually be treated with over-the-counter anti-inflammatory medications, chiropractic manipulation, physical therapy, heat, and massage. However, for those with severe symptoms, these treatments will probably only provide short-term relief.

Fortunately, there are other, more permanent options that can help you treat back pain from your breasts. This article will explore the effects of large breasts on the back, how it works, and what you can do to relieve the symptoms.

Can large breasts cause back pain?

Yes, large breasts can lead to back pain. They may also contribute to shoulder and neck pain. Known as symptomatic macromastia, the weight of large breasts can also affect other body systems.

Large breasts were shown to increase the incidence of back pain by 13% in one study. Other studies of postmenopausal women and people assigned female at birth (AFAB) over 40 suggested a link between breast size and back pain.

How back pain from breasts works

Large breasts are heavy and can shift the center of gravity, resulting in an abnormal alignment in the back and surrounding areas. When the back muscles try to adjust to the extra weight on the chest, they can become tense, which can also strain the shoulders and neck. Additionally, large breasts often result in poor posture, which can add to any back pain caused by macromastia.

As gravity pulls the breasts down, they also increase volume over time. The skin of the breasts, which is thick and heavy, increases in size as the breasts sag, adding additional weight to breast mass.

Obesity can increase breast size, but it is also an independent factor affecting back pain. Increased body mass index (BMI) is also associated with back pain. Since large breasts can result in shortness of breath and diminished exercise tolerance, this may make exercise and weight loss more difficult.

Breasts also tend to enlarge with age. Changes that occur during menopause and aging–like loss of muscle strength, bone loss, loss of tissue elasticity, etc.–can also contribute to increased breast mass.

Symptoms associated with back pain from breasts

There are several symptoms associated with back pain from breasts that may be linked to the same underlying causes:

Neck and shoulder pain

The upper back and neck include the thoracic and cervical spine. The trapezius muscle is a large diamond-shaped muscle that extends from the neck to the upper back, so a spasm in the upper back muscles can easily affect the neck and shoulders. Large breasts put continuous tension on the trapezius muscle.

Exercise intolerance

In addition to back pain, large breasts can cause discomfort when exercising. Difficulty with exercise can lead to weight gain, which may further exacerbate pain symptoms. Common signs of exercise intolerance include fatigue and shortness of breath.

Numbness

As the breast mass increases, it puts more pressure on nearby nerves, which can lead to numbness of the breasts, arms, and hands.

Considerations based on the location of back pain caused by breasts

Sometimes, the location of back pain can point to specific causes or triggers. Paying attention to where you feel pain can also help you find the right treatment options.

Lower back pain from breasts

Lower back pain from macromastia occurs when the breasts shift the center of gravity forward. The muscles of the back work to align the spine. This increases the tension in the lower back muscles, which can result in lower back pain.

Middle back pain from breasts

The mechanism of middle back pain from large breasts is a shift in the center of gravity, putting additional weight on the spine and spinal muscles.

Upper back pain from breasts

Upper back pain often occurs with macromastia. This results from strain on the upper back caused by the forward thrust of gravity, changes in posture, and increased muscle tension.

Back and neck pain from breasts

Large breasts can result in neck pain in addition to back pain. The muscles and ligaments of the neck and upper back are closely connected, so the problems associated with large breasts will affect both.

How to get relief from back pain from breasts at home

There are several options for the treatment of mild to moderate back pain from large breasts, many of which you can manage at home.

Anti-inflammatory medications

Over-the-counter nonsteroidal anti-inflammatory drugs can temporarily relieve pain and inflammation. These include drugs like ibuprofen, diclofenac, and naproxen sodium.

Ice

Ice packs can relieve acute back pain. There are also sprays available, like IcyHot and Biofreeze, that also constrict blood vessels and keep inflammatory cells and chemicals released by the immune system from the area of injury.

Heat

Applying a warm compress or heating pad to the painful area of your back can provide some temporary relief.

Massage

Massage is often helpful in relaxing tense muscles or releasing muscle spasms in the back and neck.

Gentle exercise

Yoga, swimming, and other low-impact exercise can help you build strength in your muscles, including your core. Stretches can also be helpful if your back muscles are tense. This can also relieve stress, which contributes to back pain from many different underlying causes.

Stress reduction

Stress contributes to back pain. Back pain may increase your stress level. This can create a feedback loop that will lengthen your recovery.

As a result, reducing stress can reduce your pain. Consider music, imagery, deep breathing, yoga, or enjoying nature to relieve stress and speed your recovery.

How to prevent back pain from breasts

Several measures may be somewhat effective in preventing back pain from breasts, although they may not be effective in those who have very large breasts. Nonsurgical solutions may not be effective in the prevention of back pain in people with a D cup or higher.

Choose the correct bra size

Although the research is mixed on whether incorrect bra size causes back pain, women with larger breasts are more likely to have an incorrect fit. Wearing a bra with wide straps can distribute the weight of your breasts, preventing grooves from developing in your shoulders. Remember to double your breast support when exercising by wearing a fitted sports bra.

Avoid heavy backpacks and purses

Heavy backpacks and purses result in muscle imbalance and add to the extra weight you are carrying if you have large breasts.

Weight loss

If you are overweight, weight loss can help reduce the strain on your back.

Exercise

Strength training will build your core muscles to support the muscles in the torso, including the back. Aerobic exercise will improve your capacity to utilize oxygen efficiently, which is important for healing. You may also lose weight with exercise, reducing strain on your back.

Consider nutrition

Vitamins and minerals are essential for healing muscles, bones, and connective tissue like fascia and ligaments.

• Vitamin D helps with the efficient absorption of calcium, which is necessary for bone health, but it can also help prevent muscle cramps and weakness.
• Vitamin C helps with wound healing and the production of collagen, which is necessary for bones, skin, and muscle tendons.
• B vitamins, including folate (B9), B6, and B12, help with amino acid metabolism, protein synthesis, and repair of damage to muscle cells.
• Magnesium relaxes muscles, but taking too much can be harmful. Consult with your doctor before adding a supplement., especially if you have underlying health conditions or take other medications.

Stop smoking

Smoking constricts the blood vessels and delivers hundreds of toxins to your tissues. This reduces your ability to heal from injury. It takes a much longer time to recover if you are a smoker.

When to see a doctor about back pain from breasts

Although conservative measures can be helpful for mild and moderate back pain, people with very large breasts and severe back pain should see a doctor for an evaluation and to discuss surgical options.

You should see a doctor if:

Talk to your doctor if your back pain:

• Is persistent and doesn’t respond to at-home care.
• Is severe.
• Interferes with your daily activities.
• Diminishes your quality of life.

You should go to the emergency room if:

Seek immediate medical attention if you:

• Have back pain that suddenly increases in intensity.
• Have neurological signs like weakness or numbness and tingling in your arms.

Questions to ask your doctor about back pain from breasts

• What treatment can provide long-lasting relief?
• If I lose weight, will my breast size decrease?
• Will changing my bra style or size relieve my back pain?

How a doctor can help treat back pain from breasts

If you have persistent or severe back pain, a doctor can discuss treatment options to remedy the situation.

Medications

A doctor can prescribe pain medication that may be more effective than what you can get over the counter. For example, some NSAIDs can be effective when injected, such as ketorolac (Toradol). Intravenous Tylenol is also very effective.

Physical therapy

A physical therapist can help you better understand how to align your posture and will provide exercises to strengthen the core muscles to support your back better. Physical therapists can also use treatment modalities like therapeutic ultrasound or myofascial release to relieve pain and spasms in your back muscles, at least temporarily.

Surgical breast reduction

In some cases, the only definitive solution for long-term relief of back pain from large breasts is surgical breast reduction. The procedure is known as reduction mammoplasty, usually performed by a plastic surgeon under local or general anesthesia.

During the surgery, the surgeon creates incisions on the underside of the breasts and removes fat, tissue, and skin. Reduction mammoplasty is generally an outpatient surgery; most patients return home on the same day. Recovery to full activity takes about six weeks.

Frequently asked questions: back pain from breasts

If you have large breasts and back pain, you may have many questions about your condition. Here are some questions frequently asked by patients:

How can you get back pain relief from breasts while pregnant?

Back pain related to heavy breasts while pregnant is usually temporary. Your breasts will most likely return to their original size when you stop breastfeeding. In the meantime, you can find relief by following tips like these:

• Maintain good posture. Sleeping on your side with a knee pillow can help you maintain a better sleep posture.
• Use a heating pad or warm compress on the painful muscles, or take a warm shower.
• Gentle stretches may be helpful.
• Use a bra that fits you during your pregnancy, and talk to your care provider about using a pregnancy support belt to support your lower back.
• Avoid lifting anything heavy.

When you see your prenatal care provider, they may suggest a prenatal massage. They will also be able to tell you what over-the-counter medications are safe during pregnancy.

Is there anything you should consider if you have back pain after receiving breast implants?

It is not common to have back pain due to breast implants, but it does occur sometimes. When back pain does occur, it can be persistent due to the shift in gravity and the tension that arises in the mid to upper back or shoulder. If you have severe or constant back pain after getting breast implants, you should follow up with your surgeon.

Where is back pain from large breasts typically located?

Back pain from large breasts is usually in the upper back, neck, and shoulders. Pain can occur in the lower back as large breasts and postural changes can put a strain on lower back muscles and ligaments.

What to remember about back pain from breasts

Back pain from breasts usually occurs in people with larger breasts. Those with mild to moderate back pain may get relief with conservative measures like over-the-counter pain relievers, heat, and stretching. However, if you have severe or persistent back pain from large breasts, you may need a reduction mammoplasty. Talk to your doctor to learn more about which treatment approach is right for you.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Pallabi Sanyal-Dey, MD.

Sources

MedlinePlus. "Breast Reduction: MedlinePlus Medical Encyclopedia." MedlinePlus - Health Information from the National Library of Medicine, National Library of Medicine, 3 Nov. 2023, https://medlineplus.gov/ency/article/007405.htm.

"Breast Reduction Surgery Guide." ABCS, 16 Feb. 2024, http://www.americanboardcosmeticsurgery.org/procedure-learning-center/breast/breast-reduction-guide/. Accessed 29 Nov. 2024.

Jerome D et al. "Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study." Plastic and reconstructive surgery vol. 110,7 (2002): 1644-52; discussion 1653-4. doi:10.1097/01.PRS.0000033029.01084.57, https://pubmed.ncbi.nlm.nih.gov/12447043/.

Findikcioglu, Kemal et al. “The impact of breast size on the vertebral column: a radiologic study.” Aesthetic plastic surgery vol. 31,1 (2007): 23-7. doi:10.1007/s00266-006-0178-5, https://pubmed.ncbi.nlm.nih.gov/17205252/.

Letterman, G, and M Schurter. "The effects of mammary hypertrophy on the skeletal system." Annals of plastic surgery vol. 5,6 (1980): 425-31. doi:10.1097/00000637-198012000-00003, https://pubmed.ncbi.nlm.nih.gov/6451196/.

Spencer, Linda, and Kathy Briffa. "Breast size, thoracic kyphosis & thoracic spine pain - association & relevance of bra fitting in postmenopausal women: a correlational study." Chiropractic & manual therapies vol. 21,1 20. 1 Jul. 2013, doi:10.1186/2045-709X-21-20, https://pmc.ncbi.nlm.nih.gov/articles/PMC3704920/.