Pain under the breast can cause discomfort and concern. While often localized, this sensation can stem from various underlying factors. Understanding its origins helps identify its nature and determine appropriate next steps. This article explores common reasons for pain in this area.
Common Skin Irritations
The area beneath the breast is prone to skin irritations due to its warm, moist environment and skin-on-skin friction. Intertrigo, an inflammatory rash in skin folds, is common. It appears as a red or reddish-brown rash, with itching, burning, soreness, or cracked skin, caused by moisture, heat, poor air circulation, and friction.
Fungal infections, especially Candida yeast (candidiasis), are frequent. They manifest as a bright red, raised, swollen, shiny, itchy, or painful rash. Candida thrives in moist, warm environments, and intertrigo can promote overgrowth.
Heat rash (miliaria) also causes discomfort. Blocked sweat ducts trap perspiration, leading to small, itchy, or prickly spots. Chafing from constant rubbing of skin or clothing results in raw, irritated skin. Allergic reactions to soaps, detergents, or fabrics can also cause itchy or swollen rashes.
Managing irritations involves maintaining a clean, dry, and cool environment. Wash the area with gentle soap and pat dry. Well-fitting, supportive bras made from natural, breathable materials like cotton reduce moisture and friction. Moisture-wicking powders or anti-chafing products help prevent irritation and absorb excess sweat.
Musculoskeletal and Nerve-Related Causes
Pain under the breast can originate from the chest wall’s muscles, bones, and nerves. Costochondritis, an inflammation of the cartilage connecting ribs to the breastbone, is a common cause of localized chest pain. It causes sharp, aching, or pressure-like pain worsening with deep breaths, coughing, sneezing, or upper body movement. Pain may be felt under the breast and be tender to the touch.
Rib pain from injury, strain, or muscle spasms can also manifest under the breast. A strained chest muscle occurs when fibers between ribs are torn or overstretched. Heavy lifting, sudden twists, poor posture, or severe coughing can cause this, leading to sharp pain intensifying with movement, breathing, or coughing.
Nerve-related issues, like intercostal neuralgia, involve irritation or damage to intercostal nerves. This causes sharp, burning, shooting, or aching pain that wraps around the chest or upper abdomen, including under the breast. The pain can be constant or intermittent, worsening with activities like coughing, sneezing, or deep breathing.
Shingles, caused by varicella-zoster virus reactivation, can present as pain under the breast before a rash. This nerve pain may involve tingling, burning, or sensitivity to touch. A characteristic blistering rash follows, appearing on one side of the body.
Referred Pain from Internal Issues
Pain under the breast can be referred pain, where discomfort from an internal organ is perceived elsewhere. This happens because nerve signals from organs converge on the same spinal nerves supplying the chest wall. The brain interprets these signals as originating from the chest.
Gastroesophageal reflux disease (GERD), or acid reflux, is a frequent cause. When stomach acid backs up into the esophagus, it can cause a burning sensation felt behind the breastbone, extending under the breast. Discomfort may worsen after eating, with a sour taste or difficulty swallowing.
Gastritis, an inflammation of the stomach lining, can also cause pain under the breast. This pain is described as upper abdominal, sharp or gnawing, felt beneath the breastbone and potentially radiating to the back. Nausea, vomiting, bloating, or fullness can accompany it.
Gallbladder issues (gallstones or inflammation) can cause pain radiating to the chest, including under the right breast or behind the breastbone. This gripping or gnawing pain occurs after eating, often with nausea or vomiting. Diaphragm issues can also cause pain in the upper abdomen, lower chest, or referred to the shoulder.
When to Seek Medical Attention
While many causes of pain under the breast are not serious, certain symptoms warrant prompt medical evaluation. Seek immediate emergency care if the pain is sudden, severe, or persistent, especially if it does not improve with rest. Pain with shortness of breath, dizziness, lightheadedness, or profuse sweating requires urgent attention, potentially indicating a heart attack.
Medical attention is necessary if pain spreads to the arms, neck, jaw, back, or stomach. Any sudden pressure, squeezing, tightness, or heaviness under the breastbone requires professional evaluation. If pain is accompanied by nausea, vomiting, or a history of heart disease, medical advice is important.
Beyond emergencies, consult a healthcare provider for pain under the breast that is persistent, worsening, or interferes with daily activities. This includes pain that continues daily for over two weeks, occurs in one specific area, or awakens you from sleep. Report any new lumps, breast size/shape changes, skin dimpling, nipple discharge (not related to pregnancy/breastfeeding), or unusual redness/flaky skin to a doctor.
If pain occurs after an injury, or if self-care measures like keeping the area dry and clean do not improve it, a medical consultation is recommended.