Experiencing pain under the breast is a common occurrence that can cause concern. While alarming, such discomfort is often linked to non-serious conditions. Understanding potential causes can alleviate worry and guide individuals on when to seek medical advice.
Common Localized Discomforts
Pain under the breast often originates from chest wall structures like muscles, ribs, and cartilage. One common condition is costochondritis, an inflammation of the cartilage that connects the ribs to the breastbone. This can cause sharp or dull pain, typically on one side, which may worsen with deep breaths, coughing, or movement. Tenderness is usually felt where the ribs meet the sternum.
Muscle strains in the intercostal muscles (between the ribs) can also cause pain under the breast. These strains can result from activities like heavy lifting, forceful coughing, or sudden movements. Bruised or fractured ribs can also cause similar discomfort, often following a fall, direct impact, or severe coughing. Rib injury pain typically intensifies with breathing or movement, and may include swelling or tenderness. Poor posture or ill-fitting bras can also contribute to musculoskeletal pain by stressing chest and back muscles.
Skin conditions beneath the breast are another source of localized pain, especially in warm, moist environments. Intertrigo is a common rash that develops in skin folds due to heat, moisture, and friction. This rash appears red or reddish-brown and can be raw, itchy, or painful, sometimes with a foul odor or cracked skin. Yeast infections, often caused by Candida species, frequently contribute to intertrigo, thriving in moist conditions.
Nerve-related pain can also manifest under the breast. Localized nerve irritation, such as that caused by shingles (herpes zoster), can lead to sharp or burning pain in the affected nerve pathway, sometimes even before a rash appears. This type of pain follows the distribution of nerves, which can include the area beneath the breast.
Pain Originating from Other Areas
Pain under the breast does not always stem from the immediate area; it can be referred pain from internal organs. This occurs because nerves from different organs share pathways with chest wall nerves, leading the brain to misinterpret the pain’s origin. Digestive issues are frequent culprits for referred pain here.
Acid reflux (GERD) can cause a burning sensation felt behind the breastbone or under the left breast. This occurs when stomach acid flows back into the esophagus.
Gastritis, an inflammation of the stomach lining, can cause pain radiating to or felt under the breastbone or in the upper left abdomen. Pain from gastritis can be sharp, stabbing, or burning.
Stomach or peptic ulcers are sores in the stomach or small intestine lining that typically cause dull or burning pain between the belly button and the breastbone. This pain may worsen when the stomach is empty or at night.
Gallstones, hardened deposits in the gallbladder, can cause sudden, intensifying pain in the upper right abdomen, potentially spreading below the breastbone. This discomfort, often called biliary colic, can last minutes to hours, especially after eating.
Respiratory conditions can cause pain under the breast, especially with breathing. Pleurisy, an inflammation of the pleura (lung and chest cavity lining), causes sharp or stabbing chest pain that worsens with deep breaths, coughing, or sneezing. Pain can sometimes spread to the shoulder or back. Pneumonia, a lung infection, can also cause pain under the breast when inhaling, accompanied by cough and fever.
While cardiac chest pain is a serious concern, pain under the breast is less commonly a primary symptom of heart issues compared to central chest pain. Heart-related pain, such as from a heart attack, often presents as pressure or squeezing in the center or left chest, potentially radiating to the jaw, arm, or back. However, symptoms can vary, and any chest pain with other concerning signs should be promptly evaluated.
Knowing When to Seek Medical Help
While many causes of pain under the breast are not serious, some symptoms warrant immediate medical attention. Seek emergency care if pain is severe, sudden, or accompanied by shortness of breath, chest tightness, dizziness, or excessive sweating. Pain radiating to the arm, jaw, or back, especially if it feels like pressure or squeezing, also requires urgent evaluation.
Consult a healthcare professional if pain persists daily for more than a few weeks, worsens over time, or significantly interferes with daily activities. Any pain that awakens you from sleep should be discussed with a doctor. Additional symptoms necessitating medical advice include fever, chills, significant redness or swelling in the painful area, or any changes in breast appearance. If pain develops after a fall or direct trauma to the chest, seek medical help to rule out injuries like bruised or fractured ribs.