Common Musculoskeletal Causes
Musculoskeletal issues are a frequent source of pain that feels like it's coming from underneath the breasts. This type of pain often worsens with specific movements or pressure and is typically unrelated to hormonal cycles.
Costochondritis
One of the most common causes of localized chest pain is costochondritis, an inflammation of the cartilage that connects the ribs to the breastbone. The pain can be sharp, aching, or pressure-like and is often mistaken for breast or heart-related issues. It may worsen with deep breaths, coughing, or physical activity and is characterized by tenderness when pressing on the affected area. The exact cause is often unknown, but it can follow a viral infection, chest injury, or physical strain.
Muscle Strain and Injury
Straining the chest wall muscles (pectoralis muscles) from strenuous exercise, heavy lifting, or coughing can lead to soreness and pain beneath the breasts. Similarly, a direct blow to the chest, a fall, or a fractured rib can cause localized pain, swelling, and bruising. Rest and over-the-counter pain relievers often resolve these issues.
Potential Gastrointestinal and Digestive Causes
Discomfort in the upper abdomen can sometimes radiate upward and feel like it's originating from underneath the breasts. Digestive problems are a notable source of such referred pain.
Gastroesophageal Reflux Disease (GERD)
Heartburn is a classic symptom of GERD, where stomach acid flows back into the esophagus. This can cause a burning sensation in the chest that might be mistaken for pain beneath the breastbone. A hiatal hernia, which occurs when part of the stomach pushes through the diaphragm, can also lead to GERD-like symptoms and discomfort in this area.
Gallstones
Located on the right side of the body, the gallbladder can cause pain in the upper right abdomen when blocked by gallstones. This pain can radiate to the right shoulder or chest, potentially feeling like it is under the right breast.
Hormonal and Breast-Related Factors
For many, hormonal fluctuations are a primary driver of breast pain, though issues within the breast tissue itself can also be responsible.
Hormonal Changes
Cyclic breast pain, which fluctuates with the menstrual cycle, is a very common occurrence. The pain is usually felt in both breasts, often in the upper and outer areas, and can feel dull, heavy, or aching. This is due to hormonal shifts that cause swelling and tenderness in the breast tissue. This pain typically subsides after menstruation begins.
Breast Cysts and Fibroadenomas
Fluid-filled sacs (cysts) and noncancerous solid lumps (fibroadenomas) are common benign breast conditions. While often asymptomatic, they can become tender or painful, especially if they are large or put pressure on surrounding tissue. Pain from cysts can sometimes be felt underneath the breast and may vary with the menstrual cycle.
Cardiac and Pulmonary Conditions
While less common, certain heart and lung conditions can manifest as pain under the breast and should be evaluated by a healthcare professional, especially if accompanied by other serious symptoms.
Angina and Pericarditis
Angina is a type of chest pain caused by reduced blood flow to the heart muscle. It can feel like a tight, heavy pressure and sometimes radiates to the arm, neck, or jaw. Pericarditis, inflammation of the sac surrounding the heart, can cause sharp, stabbing pain under the left breast that worsens with breathing or lying down.
Pleurisy and Pneumonia
Pleurisy is the inflammation of the lung lining and can cause sharp chest pain that intensifies with deep breaths or coughing. Pneumonia, a lung infection, can also cause chest pain along with coughing, fever, and shortness of breath.
Other Considerations
Several other factors can contribute to inframammary pain, from simple lifestyle issues to more complex medical conditions.
Poorly Fitting Bra
Wearing an ill-fitting or unsupportive bra can cause pressure and strain on the breast tissue and underlying muscles, leading to persistent discomfort. Proper support, especially during exercise, can alleviate this issue.
Large Breast Size
Larger, heavier breasts can place significant strain on the chest wall, back, and shoulders, resulting in chronic discomfort. This can be exacerbated by physical activity and poor posture.
Skin Conditions (Intertrigo)
Irritation and inflammation in the skin fold underneath the breast can cause pain and soreness. This is common in warm, moist environments and is known as intertrigo. Maintaining good hygiene and keeping the area dry can help prevent and treat this condition.
Differentiating Causes: A Comparison
To help identify the potential cause of pain under the breasts, consider the following characteristics:
| Feature | Musculoskeletal Pain (e.g., Costochondritis) | Gastrointestinal Pain (e.g., GERD) | Hormonal Pain | Cardiac/Pulmonary Pain | Breast-Related Pain (Cysts) |
|---|---|---|---|---|---|
| Sensation | Sharp, achy, pressure, tender to touch | Burning, squeezing, pressure | Dull, heavy, aching, bilateral | Sharp, stabbing, pressure, radiates | Aching, localized, sometimes tender |
| Location | Often near breastbone, ribs; localized | Can be behind breastbone; radiates | Upper/outer breast; can be bilateral | Central or left chest; can radiate | Localized to cyst location; can be bilateral |
| Triggers | Movement, deep breathing, cough, pressure | Lying down, certain foods, after meals | Pre-menstrual phase | Exertion (angina), breathing (pleurisy) | Hormonal shifts |
| Relief | Rest, heat/cold packs, anti-inflammatories | Antacids, dietary changes, upright position | Post-menstruation, supportive bra | Medical treatment for specific condition | Aspiration, anti-inflammatories |
When to Seek Medical Attention
While many causes of pain underneath the breasts are benign, some situations require immediate medical evaluation. Seek prompt medical care if you experience any of the following symptoms:
- Severe, sudden, or crushing chest pain.
- Chest pain that radiates to the jaw, arms, or back.
- Shortness of breath, dizziness, or a rapid heart rate.
- A new or persistent lump underneath the breast.
- Pain accompanied by fever, chills, or bloody discharge.
Conclusion
Pain underneath the breasts is a common symptom with a wide range of potential causes, most of which are not serious. The location, sensation, and timing of the pain can offer clues to its origin, whether it is musculoskeletal, digestive, or hormonal in nature. Simple remedies like supportive bras, pain relievers, and rest can often provide relief. However, distinguishing between benign and serious conditions is crucial. Being aware of associated symptoms and knowing when to consult a healthcare provider for a proper diagnosis is essential for effective management and peace of mind. For authoritative information on breast health, resources like the National Breast Cancer Foundation are invaluable: https://www.nationalbreastcancer.org.
