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Musculoskeletal causes of breast pain

By Renee Kam, IBCLC, Physiotherapist and Breastfeeding Counsellor.

Finding the cause of breast and/or nipple pain can sometimes be tricky and there may be more than one cause. If you’re having trouble with breastfeeding, the sooner you get help, the sooner you can sort out any problems – big or small.

Breast and/or nipple pain during lactation is most commonly related to the actual breastfeeding, for example to poor attachment, a blocked duct, mastitis or nipple infections.

However pain in breastfeeding mothers, as with anyone, can also be musculoskeletal in origin – that is, it may be caused by conditions of the bones, muscles and their attachments eg joints and ligaments. New tasks undertaken when caring for a small baby may increase the risk of a mother developing musculoskeletal pain - perhaps due to poor posture while feeding, staying in the one position for a long time, muscle imbalances, or fatigue or general stresses that can make muscles tighten up.

Musculoskeletal causes may include breast pain referred from:

  • the spine eg due to a bulging disc in the upper or middle back compressing a nerve or a problem with the joints between the vertebrae.
  • a trigger point in the large chest muscle lying underneath the breast. Trigger points are hyperirritable and hypersensitive spots in a muscle.

  • costochondritis - inflammation of the cartilage holding the upper ribs to the breastbone (sternum).

A condition called Thoracic Outlet Syndrome (TOS) can also lead to breast pain. It happens when too much pressure is placed on nerves and vessels that pass between the muscles in the neck. On the affected side, TOS can cause pain (sharp, burning or aching) in the arm, hand, side of the neck, pectoral (eg breast) area, upper back and/or armpit. Tingling can also be present. Other symptoms of TOS include weakness in the hand and arm muscles on the affected side and that hand may be colder.

A physiotherapist, or other trained musculoskeletal therapist, can help work out whether it is likely that your breast pain is musculoskeletal in origin or not and, if so, what treatment may be appropriate.

It is important to seek professional advice if your pain persists. There can be other medical causes of breast pain that could require urgent medical attention.

  The information on this website does not replace advice from your health care providers.


breastfeeding and nipple care

Breastfeeding: breast and nipple care

Breastfeeding: Breast and Nipple Care tells you what to expect as your breasts change during pregnancy and briefly covers how breastfeeding works.

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© Australian Breastfeeding Association April 2015






Last reviewed: 
Jun 2016