Scoliosis is a lateral curvature of the spine that often includes a rotational component. While primarily associated with back pain and postural changes, this condition can also lead to discomfort felt in the chest and breast area. This connection is caused by structural changes to the rib cage and surrounding muscles, rather than originating from the breast tissue itself.
How Scoliosis Causes Chest and Breast Discomfort
The spine’s abnormal sideways curve, especially when located in the thoracic section, directly affects the rib cage, which is attached to the thoracic vertebrae. This rotational component of scoliosis forces the rib cage to twist, leading to an asymmetry where one side of the chest wall may protrude more than the other. This uneven structure creates chronic physical strain on the soft tissues and muscles surrounding the area where the breast is located.
The constant postural imbalance caused by the spinal curve results in uneven muscle tension throughout the back, shoulders, and chest. Muscles on one side of the spine must work harder to maintain balance, leading to fatigue, soreness, and spasms that can radiate forward. This deep, persistent muscle strain in the chest wall is often perceived as pain within the breast. The resulting discomfort is termed “extramammary,” indicating its origin is outside of the actual breast gland tissue.
In more pronounced cases of thoracic curvature, the spine’s rotation can compress or irritate the nerves that run between the ribs, known as the intercostal nerves. These nerves radiate sensation forward along the rib cage and into the front of the chest. Irritation of an intercostal nerve can cause sharp, shooting, or burning sensations felt directly beneath or within the breast. This nerve impingement contributes significantly to the localized chest wall pain experienced by some individuals with scoliosis.
Other Common Sources of Breast Pain
Pain felt in the breast area has many potential causes unrelated to spinal alignment. The most frequent source is cyclical breast pain, which is directly tied to hormonal fluctuations during the menstrual cycle. This type of pain typically affects both breasts, often in the upper, outer portions, and intensifies leading up to a menstrual period.
Non-cyclical breast pain, which is not related to the menstrual cycle, can be caused by localized inflammation or benign tissue changes. For example, costochondritis is an inflammation of the cartilage connecting the ribs to the breastbone, causing sharp chest wall pain that can mimic breast discomfort. Other causes include benign, fluid-filled sacs (cysts) or solid lumps (fibroadenomas), which can cause tenderness in a specific spot.
Pain can also result from a strain in the pectoral muscles, which radiates into the breast area. Certain medications, including some hormonal birth control pills or antidepressants, can also cause breast tenderness as a side effect. Since pain in the breast area can stem from many different systems, a medical evaluation is necessary to accurately determine the source of the discomfort.
Seeking Medical Evaluation for Pain
Any persistent or severe pain in the chest or breast area warrants a consultation with a healthcare provider to determine the cause. Individuals should seek medical attention if the pain is localized to a single area, continues daily for more than a few weeks, or seems to be getting progressively worse. Evaluation is also necessary if the pain is accompanied by other concerning symptoms.
Concerning symptoms include:
- The discovery of a new lump
- Changes to the skin texture (such as dimpling or redness)
- Any unusual discharge from the nipple
A primary care physician can perform an initial examination to determine if the pain is musculoskeletal, hormonal, or related to the breast tissue itself. They may order imaging tests like a mammogram or ultrasound to rule out primary breast issues, especially for non-cyclical pain.
Depending on the initial findings, the physician may refer the patient to a specialist for targeted treatment. An orthopedist or a physical therapist can address the mechanical issues of the spine and chest wall contributing to scoliosis-related pain. Alternatively, a breast specialist or gynecologist can ensure the pain is not due to an underlying breast condition.