Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Musings In Front of a Victoria’s Secret Fitting Room

Maybe you don’t really need that bra; you deserve a pain-free life.

I wanted it to be different this year. I wanted to continue my climb upward in terms of the classiness of Valentine’s Day gift-giving: Two years ago it was a special edition of the Whitman’s Sampler, last year something from Frederick’s of Hollywood, and this year I wandered into Victoria’s Secret.

For many men, a venture into Victoria’s Secret is a highly visual experience, as the patron is greeted by provocatively-attired mannequins and, further back in the store, women exiting fitting rooms attired in raiment that often does not seem to fit—literally, and with no pun intended, figuratively.

And that started me considering how damaging a woman’s relationship with her breasts can be---resulting in chronic pain of both a psychological and physical nature.

At least in this country, no one can argue the impact that breast size has on the mental state of so many women. Throughout their lives, girls and women must deal with the idealized norms and how they “measure up,” as it were. There are different stereotypes along the spectrum of the alphabet soup of cup size: A girl or woman with large breasts may have to contend with unsavory assumptions about her sexuality. Obversely, that same girl or woman may feel inadequate should she have smaller breasts.

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It is therefore not surprising to see women squeezing into undergarments that don’t quite seem to fit, as they struggle with how they confront myths that don’t quite fit.

But for women with large breasts, physical and chronic pain is a reality, as their lives are often interrupted by significant neck, shoulder and back pain, and headaches. Very large breasts can place excess weight on the chest, and if there is not enough support from surrounding muscles, pain, poor posture, and eventually spinal deformity can occur. As always, the psychological component plays its role: The self-consciousness that some women feel regarding their large breasts can compel them to hunch forward in an always-failed attempt to hide their chest; this posture often worsens back pain. Research has confirmed that breast cups size D and above have the potential to alter the curvature of the spine.

Weight loss, exercise, and physical therapy can often improve the pain associated with large breasts. However, for many, breast reduction surgery may be the only way to permanently resolve the issue. Data presented by the American Society of Plastic Surgeons found that half of almost 200 women with breasts size DD or larger had almost constant back, neck, and shoulder pain; but after surgery, only 10% of this cohort continued with these pain complaints.

Returning to the drama outside the Victoria’s Secret fitting rooms, one must not forget that a badly fitted bra can contribute to health problems, as discussed in a 1999 article in the “Journal of Science and Medicine.” In 2008, the British Chiropractic Association warned that wearing the wrong bra size can lead to back pain, restricted breathing, breast pain, and poor posture. A 2008 study published in “Chiropractic & Osteopathy” found that women with large breasts tend to wear bras that are too small, while smaller-breasted women wear bras that are too large.

Women who wear bras with straps that are too tight experience increased pressure on the trapezius muscle, often leading to chronic pain. A 2009 article in “The Clinical Journal of Pain” found that tight bra straps transfer weight to muscle groups that were never designed to bear such a load, resulting in muscle fatigue followed by back, shoulder, and neck pain. Alas, even strapless bras can cause chronic pain for women with larger breasts, placing all the weight in a band around the chest, resulting in extra strain upon the rib cage and back.

Interestingly, a study published last year in “The Open Orthopaedics Journal” demonstrated the reduction in shoulder pain by not wearing a bra. This supports results published over a decade ago in “The Clinical Journal of Pain”: Women did not wear bras for two weeks, and over 80% experienced almost complete relief of shoulder pain, with symptoms returning within one hour of resuming bra use. And for those concerned about collateral damage from the shedding of this particular article of clothing, “Women’s Health Magazine,” also publishing last year, cited data that wearing a bra actually contributes to breast sag.

So, think twice, you inexperienced—and experienced—Victoria’s Secret shoppers. Maybe you don’t really need that bra. It is Valentine’s Day. Romance is in the air.

And I understand there are some nice Russell Stover coupons on the web this week.

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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