West Valley Medical Center - October 13, 2016

Large breasts. Some women say, “The bigger, the better.” Others say, “Size doesn’t matter.”

But for some ladies, large breasts are a pain in the neck — literally.

Here’s what Sara E. Wilson, FNP, a nurse practitioner at the new West Valley Spine Center, says about the relationship between breast size and back pain.

Q: What kind of back pain — and where — might women with larger breasts experience?

Sara Wilson: A woman with large breasts may experience neck pain, shoulder pain and mid- to upper-back pain.

Breast-related neck, shoulder, or back pain is caused from changes in the center of gravity or normal body alignment. Large, heavy breasts pull a woman’s upper body forward, which can cause continuous tension on the neck, shoulder, and back muscles.

When a woman’s shoulders roll forward because of the weight of her breasts, she may suffer from compression in an area called the thoracic outlet—where nerves pass through a narrow opening between the ribs, shoulder blades, and muscles. And compression there can cause upper back pain.

Q: In addition to back pain, can this issue cause other symptoms?

Sara: The weight of the breasts pulling a woman forward can cause muscle strain.

And women with large breasts tend to have a more hunched-over appearance because of the forward pull.

Large Breasts: A Pain in the Neck - And Back and Shoulders
When our body is out of alignment - like when it's slouched or forward - the muscles have to work harder and our energy expenditure is higher. This can lead to tiredness or fatigue.

Source: Sarah Wilson, FNP, Nurse Practitioner, West Valley Spine Center

Q: Does age have anything to do with this problem as well?

Sara: As a woman ages, her breasts begin to lose elasticity and fullness. This leads to a condition called breast ptosis, or sagging breasts.

In a women with large breasts, this sagging can cause an even greater pull forward — and lead to more strain on the neck, upper back, and shoulders.

Q: Are there any other factors that could play a role as to whether women with larger breasts experience back pain?

Sara: Another factor that can play a role in back, neck, and shoulder pain is weight. When women gain weight, oftentimes their breasts become larger.

So, if a woman is overweight and has large breasts, she may have even more tension on the muscles in her back. This can increase the stress on her spine.

Q: What are some ways that women who are experiencing this can alleviate their pain?

Sara: One of the best things a woman can do to alleviate upper back pain is to lose weight, which will help reduce the size of her breasts and decrease the tension on the neck, upper back, and shoulders.

It’s also important to work on core strength because it helps us maintain an upright posture with less slouching.

Choosing a bra that fits properly is important as well. For example, a bra that isn’t too tight and that has wide shoulder straps can help to reduce shoulder pain.

Q: Is breast reduction an option women should consider?

Sara: Although breast reduction may be an option for some women with large breasts who are experiencing back pain, it is an invasive treatment — which means it comes with risks. It can also be costly.

I recommend starting with more conservative measures like losing weight, increasing core strength, and increasing muscle strength in your back.

If you have tried these conservative measures and are still experiencing pain, it’s a good idea to discuss your symptoms with your primary care provider to see if treatment options — such as a breast reduction — are right for you.