Breast pain, whether it is sharp and swift or a persistent dull ache, can cause many intense worry. Here is what you need to know about this type of pain, along with ten potential causes of breast pain.

What is breast pain?

It’s important to get two myths out of the way quickly.

First, breast pain is not a major symptom of breast cancer. While some women do experience breast pain as a symptom that leads to a cancer diagnosis, the vast majority of breast pain does not indicate cancer.

Additionally, although many women know they are pregnant by their tender and swollen breasts, not every woman who gets pregnant experiences this as an indicator of pregnancy.

Breast pain is something that many women experience at multiple stages of life, and for many different reasons. The breasts are connected to the pectoral muscles on the front of the chest. Superficial and deep fascia surround adipose tissue, ducts, and the nipple areola complex. Stroma, another form of connective tissue, forms a web that encases the ducts and attaches them to the fascia.

Breast pain and soreness occurs for many different reasons, but it can be deeply uncomfortable. The breast and surrounding muscles can be the cause of the soreness, which can range from mild to severe.

This type of pain is not confined to just girls and women. Men can experience breast pain as well, through all stages of their lives. While men do not have the duct system that women do, an estimated 50 to 70% of men have something called gynecomastia, or excessive breast tissue. Because of this, many of the potential breast pain causes below apply to both men and women.

What are common breast pain causes?

It’s important to know that the level of pain does not necessarily indicate the severity of its cause. Knowing some common breast pain causes can help ease your mind so you can proceed with preventative self-care.

Here are ten potential causes of breast pain:

  1. Hormonal fluctuations
  2. Injuries
  3. Chest wall pain
  4. Exercise
  5. Wearing an ill-fitting bra or sports bra
  6. Breast pain after menopause
  7. Pregnancy
  8. Breastfeeding issues
  9. Certain medications
  10. Pain after breast cancer and treatment

Let’s look at each of these in more detail.

1. Hormonal fluctuations

The normal hormonal fluctuations of your monthly menstrual cycle are one of the major causes of this type of pain. In the three to five days before menstruation, estrogen and progesterone production increases, causing the breasts to swell and become tender.

Women with fibrocystic breasts – those with denser, more fibrous breast tissue – are more prone to breast pain due to fluctuations in their monthly cycle.

2. Injuries

As with any part of the body, breasts are subject to injury due to an accident, sports mishap, or surgical damage (i.e., in a breast surgery).

The injured breast may swell, or a lump might appear. You might experience swelling or redness or a bruise that persists. Left untreated, some breast injuries can become infected.

3. Chest wall pain

The chest wall is the pectoral muscles, skin, and fat that protect the heart, lungs, and liver in your upper body. Located in the middle of the body where the thoracic skeleton lies, chest wall pain can occur when there is stress, strain, or fracture to the muscles, ligaments, or bones in this area.

This can occur in both men and women, but in women it may feel like breast pain.

4. Exercise

It is ironic that exercise—something good for you—could lead to something that feels bad. The pectoral muscles of the chest wall are just as subject to strain and stress as any other muscle in the body. Just as your glutes complain after one too many squats, so too might your pectoral muscles ache after bench presses or push-ups.

While technically not pain in the breast itself, you may experience it that way.

5. Wearing ill-fitting bra or sports bra

Although proper support is important for women of all sizes, wearing an ill-fitting bra or sports bra can be a main cause of breast pain in women with larger breasts.

Large breasts that are not properly supported can stretch the Cooper ligament that supports the breasts, causing soreness and an ache that feels like a pulled muscle (but can take longer to heal).

6. Breast pain after menopause

Menopause is defined as cessation of menstruation. Women technically enter menopause after one full year without a period. This means that the hormonal causes of breast pain are no longer, relevant, right?

While mostly this is correct, some women do take hormonal support after menopause that mimics the menstrual cycle somewhat and may result in breast pain after menopause.

7. Pregnancy

Pregnancy symptoms are often lumped together and presented as absolutes. If you experience breast pain, though, pregnancy is only a given when you get a “plus” sign on your home test (or a doctor’s confirmation).

The same hormones that cause monthly breast tenderness in some women are also responsible for breast pain during pregnancy, but it’s not a given. Some women experience their entire pregnancy with nothing more than mild soreness—if anything at all.

8. Breastfeeding issues

Another powerful myth surrounding pregnancy and breastfeeding is that the body will naturally take to breastfeeding, and mother and child will relax happily into a regular, easy rhythm. It is true that female human beings are designed to nurse, with milk ducts and the biological mechanisms for producing milk, but there are many other factors involved in pain-free breastfeeding.

Many women struggle to find a comfortable position in which to nurse. Babies may also struggle to latch on, causing extreme nipple soreness and chapping. Nursing mothers may also experience clogged milk ducts, or milk ducts that become painfully infected (mastitis).

9. Certain medications

Some medications have breast pain as a side effect. These include:

  • Oxymethone: Common treatment for some forms of anemia
  • Chlorpromazine: Used to treat mental health conditions
  • Diuretics for kidney and heart disease and high blood pressure
  • Birth control pills, hormone replacement, or infertility injections
  • Digitalis: Commonly used for patients with heart failure
  • Methyldopa: High blood pressure treatment

It may be possible to use an alternative medication for these conditions. Talk to your doctor about your options.

10. Pain after breast cancer and treatment

It hardly seems fair, but even after breast cancer treatment (such as mastectomy), some breast cancer survivors experience lingering pain that can become chronic.

There are many theories about why this happens, but as with every woman, each cause is different. Some researchers believe that mastectomy may damage sensitive nerves behind the breasts. Others point out that damaged nerve tissue in the underarm is the reason breast pain persists past the expected recovery period.

When to worry about breast pain

If you have sharp breast pain that occurs without apparent cause or a painful lump in the breast, talk to your doctor. As stated above, breast pain is rarely a sign of breast cancer, but it’s important to check in. A painful lump could be a sign of a noncancerous cyst that requires draining. If you have breast implants, it could also indicate a leak. Your doctor will take a look with an ultrasound and work with you on the best course of action.

Also seek medical attention if you experience any clear or bloody discharge from the nipple, persistent pain, and any sign of infection (e.g., pus or redness and fever).

How to manage breast pain

You can manage most forms of breast pain with a combination of prevention and compassionate self-care.

The first step is diagnosing and treating the underlying cause. After that, there are a variety of ways to find comfort.

Schedule routine breast exams (to minimize worry over cancer)

Although breast pain is rarely caused by cancer, routine breast exams by your doctor can help ease your mind.

This includes getting a regularly scheduled mammogram after you reach 50 years of age.

Perform regular breast self-exams

Learning to do a breast self-exam is also an excellent way to get to know the landscape of your breasts and can help you identify any changes earlier. In fact, the National Breast Cancer Foundation notes that 40% of breast cancers are detected by a breast self-exam.

A breast self-exam can be done in the shower or lying down, the same time every month and preferably not when breasts are swollen or already tender. Make sure to visually examine your breast after the shower, too, looking for visible changes.

Track your menstrual cycle

Tracking your menstrual cycle is one of the best ways to treat hormone-related pain. In the week leading up to your period, you can take a few steps that help minimize swelling and breast tenderness, including:

  • Reduce or eliminating caffeine intake
  • Reduce salt intake
  • Avoid smoking and alcohol consumption
  • Eat a healthy diet (minimize poor-quality fat, sugar, and processed foods)
  • Consider over-the-counter pain relievers

If breast pain persists and you are on birth control, switching to a new prescription may help. Talk to your doctor about your options.

Attend routine medical appointments

Remember your routine doctor’s appointment, the one where a general practitioner assesses your overall health? Don’t neglect those. Even if you feel perfectly fine and have no issues, preventative medicine is the best kind. Your primary care physician keeps track of your baseline level of health and can notice when things start to change.

With new online patient portals, you can also see all of your important medical information in one place.

Use hot and cold therapy

Hot and cold therapy can feel miraculous on sore, swollen breasts. The one to choose is the one that works best for you. If you are breastfeeding and your breasts feel warm when they are engorged, a cold compress might be comforting.

If pain originates in a pulled muscle behind the chest wall, a hot water bottle or heating pad may help to loosen and relaxed the strain. Experiment to see whether hot or cold provides the most relief.

Find the correct bra 

If you have breast pain caused by bras, it’s time to get properly fitted. There are boutiques that specialize in this, but many larger department stores offer complimentary bra fittings for not only sports bras but also everyday support.

You may need to spend a little more for better support, but it will be worth it to go about your day without pain.

Mind your magnesium

Multiple studies have found that taking a magnesium supplement (or a magnesium supplement with B6) reduced breast pain, weight gain, tension, and irritability in women who regularly suffered from these during their menstrual cycle.

Try over-the-counter pain medicine

Over-the-counter pain medicine can help relieve soreness and pain but use it sparingly. Try comfort measures first. And, if you are nursing, check with your doctor before taking any new medications.

Some prescription drugs are approved to treat some forms of breast pain, but they may come with side effects and are not generally recommended for women who are breastfeeding.

Get help

If you are experiencing breast pain and you’re in Arizona, the team at Arizona Pain can help. Our compassionate doctors will work with you to develop a supportive, comprehensive treatment plan that works for you.

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