{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T21:09:11Z","timestamp":1770844151705,"version":"3.50.1"},"reference-count":16,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to musculoskeletal pain and reduced quality of life. This study aimed to evaluate the association between breast size and back pain in a general orthopedic population of young women. Materials and Methods: A cross-sectional study was conducted among 200 women aged 18\u201336 who attended orthopedic clinics for non-spinal complaints. Data were collected via structured telephone questionnaires, including demographics, self-reported breast size (cup and band), pain characteristics, and SF-12 quality of life scores. Binary logistic regression, ANOVA, and chi-square analyses assessed associations between breast size, pain presence, severity, and functional outcomes. Results: Back pain prevalence increased with breast size: only 4.9% of B cup participants reported backache, compared to 85% of DD\/E cup participants. VAS scores rose from 0.3 \u00b1 1.6 (B cup) to 6.0 \u00b1 2.9 (DD\/E cup). Each 1 cm increase in band length raised the odds of back pain by 19.8% (OR = 1.198, p &lt; 0.001), while large cup size was associated with up to 12-fold increased odds of pain. Larger breast size was also significantly associated with work limitations and social impairment. Conclusions: Breast size was strongly associated with the presence and severity of back pain, particularly in the thoracic and cervical regions. Clinicians should consider breast size in the assessment of backache, and reduction mammaplasty may have therapeutic value beyond aesthetics.<\/jats:p>","DOI":"10.3390\/medicina61081353","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:57:24Z","timestamp":1753689444000},"page":"1353","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Female Breast Size, Backache, and Quality of Life in Young Women: A Cross-Sectional Study"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7968-7906","authenticated-orcid":false,"given":"Raphael","family":"Lotan","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natali","family":"Marmor","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Plastic Surgery, Wolfson Medical Center, Holon 5822012, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Weiss","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Plastic Surgery, Wolfson Medical Center, Holon 5822012, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-8106","authenticated-orcid":false,"given":"Mojahed","family":"Sakhnini","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2975-9152","authenticated-orcid":false,"given":"Oded","family":"Hershkovich","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Wolfson Medical Center, Holon 5822012, Israel"},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1746-1340-13-13","article-title":"The epidemiology of low back pain in primary care","volume":"13","author":"Kent","year":"2005","journal-title":"Chiropr. Osteopat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1533","DOI":"10.1002\/hsr2.1533","article-title":"Non-spinal low back pain: Global epidemiology, trends, and risk factors","volume":"6","author":"Shokri","year":"2023","journal-title":"Health Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/PRS.0000000000005319","article-title":"Effect of breast size on upper torso musculoskeletal structure and function: A cross-sectional study","volume":"143","author":"Coltman","year":"2019","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.clinbiomech.2017.12.009","article-title":"Upper torso pain and musculoskeletal structure and function in women with and without large breasts: A cross sectional study","volume":"51","author":"McGhee","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Petronilla, O.C., Chinecherem, E.P., and Sunday, E.S. (2024). Breast size, thoracic kyphosis, and thoracic spine pain: A correlational survey of Nigerian postpartum mothers. BMC Musculoskelet. Disord., 25.","DOI":"10.1186\/s12891-024-07978-x"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1007\/s00266-022-03141-w","article-title":"The effect of breast size on spinal posture","volume":"48","author":"Michalik","year":"2024","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"741","DOI":"10.3233\/BMR-160680","article-title":"Breast size impacts spine motion and postural muscle activation","volume":"29","author":"Drake","year":"2016","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1093\/aje\/kwt019","article-title":"Associations of body mass index and body height with low back pain in 829,791 adolescents","volume":"178","author":"Hershkovich","year":"2013","journal-title":"Am. J. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Spencer, L., McKenna, L., Fary, R., Jacques, A., and Briffa, K. (2019). Upper back pain in postmenopausal women and associated physical characteristics. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0220452"},{"key":"ref_10","first-page":"453","article-title":"Breast hypertrophy and dorsolumbar spine. Prognostic influences of lumbar lordosis: Preliminary results","volume":"58","author":"Fouquet","year":"1991","journal-title":"Rev. Du Rhum. Et Des Mal. Osteo-Articul."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Spencer, L., Fary, R., McKenna, L., Jacques, A., and Briffa, K. (2022). Taking the strain: An examination of upper back musculoskeletal tissue sensitivity in relation to upper back pain and breast size. A cross-sectional study. Clin. Biomech., 92.","DOI":"10.1016\/j.clinbiomech.2022.105571"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1097\/PRS.0b013e3181b988aa","article-title":"The impact of breast reduction surgery on low-back compressive forces and function in individuals with macromastia","volume":"124","author":"Foreman","year":"2009","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1097\/01.prs.0000254358.55104.9f","article-title":"Functional capacity and postural pain outcomes after reduction mammaplasty","volume":"119","author":"Freire","year":"2007","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mian, S., Dyson, E., and Ulbricht, C. (2020). Reduction mammoplasty and back pain: A systematic review and meta-analysis. Eur. Spine J., 497\u2013502.","DOI":"10.1007\/s00586-019-06155-2"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.spinee.2024.10.009","article-title":"Back Pain in Patients with Macromastia: What a Spine Surgeon Should Know?","volume":"25","author":"Aref","year":"2025","journal-title":"Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/229255031302100114","article-title":"Reduction mammoplasty improves body posture and decreases the perception of pain","volume":"21","author":"Goulart","year":"2013","journal-title":"Can. J. Plast. Surg."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/8\/1353\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:16:26Z","timestamp":1760033786000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/8\/1353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,26]]},"references-count":16,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["medicina61081353"],"URL":"https:\/\/doi.org\/10.3390\/medicina61081353","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,26]]}}}