Breasts can feel heavy and sore for many reasons. Menstruation, pregnancy, and nursing are some examples of common reasons. Less commonly, breast pain may stem from cancer.
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.
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Cyclical breast pain develops as a result of menstrual periods. The pain usually affects both breasts and intensifies a couple of weeks before the start of the period. The pain should lessen when bleeding starts.
Noncyclical breast pain develops as a result of anatomical changes within the breast, such as injury, surgery, or breast cysts.
The pain is often localized and can be described as sharp or burning. Noncyclical breast pain does not vary with a person’s menstrual cycle. The pain typically occurs in a single location and does not disappear.
Treatment
The type of treatment will depend on the severity of the pain, the age of the person experiencing mastalgia, and the underlying cause.
To help relieve symptoms of mastalgia, a person can try the following:
- wear a well-fitting sports bra during physical activity
- apply warm compresses
- taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)
Other ways to relieve cyclical breast pain may include:
Medication may include:
- birth control
- thyroid hormones
- estrogen blockers
- danazol, which is a male hormone
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.
Treatment
A person can try the following to ease breast pain during pregnancy:
- wear a maternity bra that fits correctly
- wear a soft bra to sleep in
- apply hot or cold packs to the breast
It is possible to take some pain medications, such as paracetamol, during pregnancy. However, a person should speak with a doctor before taking medications when pregnant.
When nursing, a person’s breast can feel sore and heavy.
Once the baby is born, the breasts can become engorged. This happens when the breasts become overly full of milk, causing them to feel hard, painful, and tight. The milk supply can take a few days to match the infant’s needs.
Engorgement can cause:
- breast swelling and tenderness
- warmth
- skin discoloration
- throbbing
- low grade fever
- flattening of the nipple
Treatment
A person
- nurse or express the milk often after giving birth
- express or pump a small amount of milk to soften the breast before nursing
- apply a cold compress in between feedings
- wear a well-fitting and supportive bra
- get plenty of rest, nutrition, and fluids
Another method is applying a cabbage leaf to the breasts. This may help cool the breast and provide relief. A 2020 article found that cold cabbage leaves could relieve breast hardness, and room-temperature cabbage leaves could provide some relief for breast engorgement.
An infection in the breast can cause breast pain. Two common infections include:
Mastitis
Mastitis can happen after a long period of engorgement or when the milk ducts become plugged.
Symptoms may include:
- fever
- chills
- a warm or swollen area on the breast
- nausea
- fatigue
- vomiting
- yellow discharge from the nipple
Treatment
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 nursing if they have mastitis and are taking antibiotics.
Thrush or yeast infection
A yeast infection is a type of fungal infection.
Symptoms may include:
- sore nipples
- nipples that are flaky, shiny, cracked, and itchy
- aching breasts
- white spots on the infant’s tongue, gums, or cheeks
The person who is nursing may feel a hot stabbing pain in the breast after the feeding.
Treatment
A person can treat thrush with medications, including antifungal ointment and nystatin suspension for the infant’s mouth.
A person can prevent thrush from 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 nursing and treating both the baby and themselves for thrush. However, they should also see a doctor, as oral medications can help.
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.
Treatment
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.
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
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
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 contact a doctor for:
- signs of an infection during nursing, especially if they feel feverish or unwell
- intense breast pain during or after nursing
- 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.
Sore and heavy breasts have a variety of possible causes.
Hormones, pregnancy, and nursing can all cause a person’s breasts to feel heavy and sore.
In many cases, lifestyle changes can ease breast pain. If the pain returns or causes anxiety, a person should contact a doctor. A quick physical exam can usually help diagnose the cause and determine the right treatment.