When the breasts feel heavy and sore, a woman may fear that there is a serious underlying cause. However, breast tenderness has a variety of causes, most of which are nothing to worry about. Many different conditions can cause breast pain. Hormonal changes, breast infections, and pregnancy may play a role.
In this article, we’ll discuss the potential causes of heavy, sore breasts, as well as pain relief methods.
1. Mastalgia
Mastalgia is a possible cause of heavy and sore breasts. There are two types of mastalgia. The first is cyclical breast pain, which menstrual periods typically cause. The second is non-cyclical breast pain, which can originate either in the breast or in the muscles and joints around it. Cyclic breast pain usually occurs around the time of ovulation and continues until the start of the menstrual cycle. The pain can occur in only one breast or both, and it can range from mild to severe. Pain can also manifest in the armpits.
Noncyclical breast pain does not vary with a person’s menstrual cycle. The pain usually occurs in one place and does not go away. Trauma, a blow to the chest, and arthritis pain can all cause noncyclic pain.
Treatment
Warm compresses and pain medications, such as ibuprofen, can help relieve cyclical breast pain.
Other ways to relieve cyclical breast pain may include the following
– reduce caffeine consumption
– increase the consumption of vitamin E
– adopt a low-fat diet
2. Pregnancy
Breasts can feel tender or heavy during pregnancy, including during the first trimester. Progesterone can cause breast tenderness. This hormone contributes to the maintenance of pregnancy, and also increases in the second half of the menstrual cycle. As the pregnancy progresses, the breasts get bigger. This growth can cause pain if the person’s bra is too tight. It can also make the breasts heavier and cause pain in the shoulders and back.
When the breasts start producing milk, it can cause unusual sensations in the breasts or a feeling of fullness or heaviness. Sometimes it can also cause pain.
Treatment
A properly fitted maternity bra can help reduce any pain you may have. According to a 2016 systematic review, a woman can also try applying cold and hot packs intermittently to painful areas for 20 minutes twice a day to reduce pain. The pain is usually not severe enough to require medication.
3. Breastfeeding
After childbirth, breastfeeding can be painful and the breasts can be heavy. The breastfeeding woman and infant need to get used to the flow of milk production and a new routine. After the first 48 hours, engorgement may occur, i.e. the breasts become heavy and full of milk. Breasts can appear large while being full, heavy and very sensitive.
Treatment
A woman can relieve these symptoms:
– breastfeeding or expressing milk at least every 2 hours
– by gently massaging the breasts
– use warm compresses, such as hot towels, before breastfeeding
– express a little milk to soften the area around the nipples and encourage the baby to latch on
– use a cold compress, such as a bag of frozen vegetables wrapped in a towel, after breastfeeding
Another method is to apply a cabbage leaf to the breasts. Doing this can help cool the breast and provide relief. In a 2015 clinical trial, participants who used a cabbage compress had significantly lower breast hardness compared to those who did not receive this treatment. Women should not use cabbage for more than 24 hours. The engorgement disappears in about 48 hours, although the person may still experience mild engorgement if the baby is slow to feed.
4. Infections
A breast infection can cause breast pain. Two of the most common infections are:
– Mastitis
Mastitis can occur after a long period of engorgement or when the milk ducts become blocked.
Symptoms may include:
fever
chills
a warm or swollen area on the breast
nausea
fatigue
vomitings
yellow discharge from the nipple
Treatment
A doctor can prescribe antibiotics to treat the infection. Warm compresses may also be helpful. A woman with mastitis and on antibiotics can continue to breastfeed safely.
– Thrush or yeast infection
A yeast infection is a type of fungal infection. Symptoms may be as follows
– sore nipples
– pink, scaly, shiny, cracked and itchy nipples
– sore breasts
– white spots on the infant’s tongue, gums or cheeks.
A nursing woman may feel a hot, stabbing pain in the breast after feeding.
Treatment
Thrush can be treated with medications, including
– an antifungal ointment
– suspension of nystatin for the mouth of the infant
5. Fibrocystic breasts
Fibrocystic breast disease causes harmless lumps in the breasts. The breasts may feel heavy or full. Fibrosis occurs when there is thickening of the breast tissue. It can cause nipple discharge and breast pain.
Treatment
Fibrocystic breasts can be treated and symptoms relieved by:
– using a hot or cold compress
– wearing a comfortable bra
– avoiding salt, caffeine and fats
– taking oral contraceptives
– taking over-the-counter pain relievers.
If a cyst is bothersome, a doctor can drain the fluid in it.
6. Cancer
Most breast cancers do not cause pain. However, if a woman experiences breast pain that does not go away, she should see a doctor to rule out cancer.
Other symptoms are as follows
– bloody discharge from the nipple
– changes in the skin around the nipple or turning the nipple inwards
– warmth or itching in the breasts, although this could be mastitis
– thickening of the skin, or skin whose texture resembles orange peel
– swelling or bumps around the collarbone and armpits
– a lump in the breast, usually hard and painless.
Treatment
Treatment usually consists of
– removal of the entire tumor, which can lead to a mastectomy
– chemotherapy, which can shrink the tumor
– radiotherapy, which destroys cancer cells.
When to consult a doctor
Most cases of breast pain go away on their own. A woman does not need to see a doctor if the pain goes away and does not come back, or if she has cyclical breast pain that is not unbearable.
However, a person should see a doctor if:
– signs of infection while breastfeeding, especially if she has a fever or is not feeling well
– severe breast pain during or after breastfeeding
– a lump in the breast, especially a hard lump that does not go away after menstruation
– a discharge from the nipple
– any breast pain that is severe or unbearable.
Tracking breast pain over time can help the doctor make a correct diagnosis. It is important to tell the doctor if the pain got progressively worse or if it started after an injury.
Sources
Benign breast problems and conditions. (2017).
Breast cancer: Overview. (2017).
Breast pain (mastalgia). (nd).
Malherbe, K., & Fatima, S. (2019). Fibrocystic breast disease.
Mangesi, L., & Zakarija-Grkovic, I. (2016). Treatments for breast engorgement during lactation.
