At first glance a 1996 court ruling about breast size might appear to have little to do with neck pain, but the ruling in this case supported the notion that breast reduction surgery is medically necessary to relieve neck pain, headaches, and shoulder pain in some patients. So how do heavy breasts cause neck pain, if at all, and what can you do about it?
If you don’t have big breasts then it’s unlikely you’ll understand the effect that they can have on your posture, mobility, and experience of pain. Imagine strapping two five pound bags of sugar to your chest and carrying them around all day and night.. for the rest of your life. You might find that your shoulders roll forwards, that your back aches, and that you’re even suffering from abnormal sensations in your fingers from pinched nerves in the arm, neck and shoulder. To counteract the downward slump of the shoulders you might end up sticking your neck farther out, with this hyperextension straining the ligaments and putting extra pressure on the spinal discs and vertebrae.
Breast Size, Posture, and Neck Pain
In addition to the simple physics involved in having a heavy weight in the anterior chest, macromastia (very large breasts) can also affect posture in another way, by influencing a person’s self-esteem and confidence. In men, gynaecomastia (a benign enlargement of breast tissue in men) can also affect posture and contribute to neck pain. A person may slump forward in an attempt to hide their breasts, rather than keeping their shoulders back and head up. The result is hyperextension of the neck and likely strain and pain.
Small Breasts and Neck Pain
Conversely, those with small breasts or no breast development, and women who have undergone a mastectomy may also develop neck pain. When a person lacks confidence in their body, as can happen after illness or when judging oneself against the moving target of a society’s standards of beauty, posture is rarely erect and confident. Instead, a shy, slumped, head down posture may be adopted, with the same effects as above in regards to neck strain and pain.
Heavier Breasts Linked to Neck Pain
Surprisingly, little research has been done to find out what, if any, association exists between neck pain and breast size. However, a study by Myint et al (2012) did find that neck pain and bra size were linked, but not bust size. Unfortunately, this research was done through a survey that women filled out for themselves, rather than with independent assessments of women’s breast size, bra size, and pain. As so many women wear an ill-fitting bra it may be difficult to make generalisations from such a study.
The size of a woman’s breasts may not, in some cases, be the determining factor in neck pain development as many women have small but fibrous and heavy breasts whereas others may have large, lighter breasts that do not strain the muscles in the chest and back quite so much. Heavy breasts can cause bra straps to cut grooves into the shoulders, or result in tightness across the chest because of the need for a sturdy bra band.
The Right Fit for Neck Pain
Bras are designed to support the breasts from below, so if your bra’s band is loose and all the weight of your breasts is sitting on your shoulders it is time to get fitted for a new bra. Having a variety of bras that have straps that sit in a slightly different location on your shoulders can also help avoid the development of a bra groove and sore muscles or pressure sores. Having the right fitting bra may help relieve chronic neck pain and headaches. It can also boost confidence which then affects posture, itself helping reduce the risk of neck pain. Some women find that a racer-back style bra can help keep the shoulders back and head upright, reducing neck pain while supporting the breasts.
Getting a proper bra fitting can reveal a cause of neck pain that had not been previously considered. As well as helping support the breasts, reduce ligament damage in the chest, and make life more comfortable in general, a properly fitted bra could help relieve headaches, shoulder pain, spinal degeneration, and neck pain caused by heavy breasts. Women whose breasts have grown or changed due to pregnancy and breastfeeding may also find that their bras no longer fit properly, necessitating a new collection to prevent neck pain while breastfeeding and after weaning.
What to do if You Suspect Your Breasts of Causing Neck Pain
In some cases, breast reduction surgery for excessively large breasts that affect quality of life may, like in the 1996 ruling, be deemed medically necessary to relieve neck pain, headaches, shoulder pain, and paraesthesia. The first step, however, is making sure that you are wearing the correct bra size and feeling supported. If you’ve ruled out lots of other causes of neck pain then perhaps it’s time to ask if the answer is actually staring your doctor in the face.
Myint Oo, Zhuo Wang, Toshihiko Sakakibara, and Yuichi Kasai, Relationship Between Brassiere Cup Size and Shoulder-Neck Pain in Women, Open Orthop J. 2012; 6: 140–142.