When the breasts feel heavy and sore, a person might worry that there is a serious underlying cause. However, breast tenderness has a variety of causes, most of which are not a cause for concern.
Many different conditions can cause breast pain. Hormonal shifts, breast infections, and pregnancy may play a role.
In this article, we will discuss the potential causes of heavy and sore breasts, as well as methods of pain relief.
There are two types of mastalgia. The first is cyclical breast pain, which menstrual periods typically cause. The second is noncyclical breast pain, which can come from either the breast or the muscles and joints surrounding it.
Cyclical breast pain typically occurs at the time of ovulation and continues until the start of the menstrual cycle.
The pain may occur in one or both breasts, and it can range from mild to severe. The pain can also occur in the underarms.
Noncyclical breast pain does not vary with a person’s menstrual cycle. The pain typically occurs in a single location and does not disappear. Trauma, a blow to the chest, and arthritic pain can all cause noncyclical pain.
Warm compresses and pain medication, such as ibuprofen or acetaminophen, may help with cyclical breast pain.
Other ways to relieve cyclical breast pain may include:
- reducing caffeine intake
- increasing intake of vitamin E
- eating a low fat diet
Medication may include:
- birth control
- thyroid hormones
- estrogen blockers
- danazol, which is a male hormone
The type of treatment will depend on the severity of the pain and the age of the person experiencing mastalgia.
The breasts may feel tender or heavy during pregnancy, including in the first trimester.
Progesterone can cause breast tenderness. This hormone helps maintain pregnancy and also surges in the second half of a person’s menstrual cycle.
As pregnancy progresses, the breasts grow. This growth can cause pain if a person’s bra is too tight. It can also make the breasts feel heavier, potentially causing shoulder and back pain.
When the breasts begin to produce milk, this can cause unusual sensations in the breast or a feeling of fullness or heaviness. It can sometimes also cause pain.
A maternity bra that fits correctly may help alleviate any pain.
According to a 2016 systematic review, a person can also try applying cold and hot packs intermittently to the sore areas for 20 minutes twice a day to reduce pain.
The pain is not usually bad enough to require medication.
After delivery, breastfeeding can be painful, and a person’s breasts can feel heavy.
The person breastfeeding and the infant have to get used to the flow of milk production and a new routine.
After the first 48 hours, engorgement can occur, which is when the breasts become heavy and full of milk.
The breasts may look large while feeling full, heavy, and very sensitive.
A person can relieve these symptoms by:
- breastfeeding or expressing milk at least every 2 hours
- massaging the breasts gently
- using warm compresses, such as warm towels, before breastfeeding
- expressing some milk to soften the area around the nipples and encourage the baby to latch on
- using a cold compress, such as a towel-wrapped bag of frozen vegetables, after feedings
- standing in the shower
Another method is applying a cabbage leaf to the breasts. Doing this may help cool the breast and provide relief. In a 2015 clinical trial, the participants who used a cabbage compress had significantly lower breast hardness compared with those who did not receive this treatment.
People should not use cabbage for more than 24 hours. Engorgement goes away within about 48 hours, although the person may still experience mild engorgement if the baby is late to feed.
An infection in the breast can cause breast pain.
Two of the most common infections include:
Mastitis can happen after a long period of engorgement or when the milk ducts become plugged.
Symptoms may include:
- a warm or swollen area on the breast
- yellow discharge from the nipple
A doctor may prescribe antibiotics to treat the infection. Warm compresses may also help.
According to The American College of Obstetricians and Gynecologists, it is safe for a person to continue breastfeeding if they have mastitis and are on antibiotics.
Thrush or yeast infection
A yeast infection is a type of fungal infection.
Symptoms may include:
- sore nipples
- nipples that are pink, flaky, shiny, cracked, and itchy
- aching breasts
- white spots on the infant’s tongue, gums, or cheeks
The person who is breastfeeding may feel a hot stabbing pain in the breast after the feeding.
A person can treat thrush with medications, including:
- antifungal ointment
- nystatin suspension for the infant’s mouth
- gentian violet, which a person can use daily, but for no longer than 7 days
A person can prevent thrush reoccurring by:
- washing bras and clothes in hot water with bleach
- using disposable diapers until the infection is gone or washing cloth diapers in very hot water
- rinsing the nipples with a vinegar-and-water solution after feeding
If the yeast infection persists, a person should continue breastfeeding and treating both the baby and themselves for thrush. However, they should also see a doctor, as there are oral medications that can help.
5. Fibrocystic breasts
Fibrocystic breast disease causes harmless lumps in the breasts. The breasts may feel heavy or full.
Fibrosis occurs when there is a thickening of the breast tissue. It may cause nipple discharge and breast pain.
A person can treat fibrocystic breasts and alleviate the symptoms by:
- using a warm or cold compress
- wearing a comfortable bra
- avoiding salt, caffeine, and fat
- taking oral contraceptives
- taking over-the-counter pain relievers
If there is a cyst that is bothersome, a doctor may drain the fluid from it.
Most breast cancers do not cause pain. However, if a person experiences breast pain that does not go away, they should see a doctor to rule out the possibility of cancer.
Other symptoms include:
- nipple discharge that is bloody
- changes in the skin around the nipple or the nipple turning inward
- breast warmth or itching, although this could be mastitis
- skin thickening, or skin that has a texture resembling an orange peel
- swelling or lumps appearing around the collarbone and underarms
- a lump in the breast that is usually hard and painless
Treatment typically involves:
- removing all of the tumor, which can result in a mastectomy
- chemotherapy, which can shrink the tumor
- radiotherapy, which can destroy the cancerous cells
When to see a doctor
Most cases of breast pain go away on their own. A person does not need to see a doctor if the pain disappears and does not return, or if they have cyclical breast pain that is not unbearable.
However, a person should see a doctor for:
- signs of an infection during breastfeeding, especially if they feel feverish or unwell
- intense breast pain during or after breastfeeding
- a lump in the breast, especially a hard lump that does not go away after a person’s period
- discharge from the nipple
- any breast pain that is severe or unbearable
Tracking breast pain over time can help a doctor give a proper diagnosis. It is important to tell the doctor if the pain has worsened progressively or if it first appeared after an injury.
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