An Alternative Conservative Approach For Managing Non-Specific Back Pain Amongst Larger Breasted Women?

Abstract

BACKGROUND
It is well known that due to current measurement, sizing and fitting approaches, poor bra fit is prevalent amongst larger breasted women. It is proposed to be a causal factor in the development of negative health outcomes including non-specific back pain (NSBP). Correcting poor bra fit may provide significant symptomatic relief, although this hasn’t yet been explored
As a self-management strategy, this conservative approach may provide women with independence, empowerment and
active involvement in the long-term management of their pain.

AIM
To determine the potential effectiveness of an alternative approach for managing chronic NSBP amongst larger breasted women, this study aimed to explore immediate and short-term biomechanical, psychosocial and pain responses to changing breast support garment amongst symptomatic and non-symptomatic participants.

METHOD
Asymptomatic participants (n=24) performed a static standing task, drop jumps and seated typing whilst kinematic data from the breasts and spine were recorded. Three breast support conditions were assessed: Usual, professionally fitted bra in the immediate term (PFB), and after four weeks wear (PFB28). Bra fit assessments were included for both bras. Measures of conscious motor processing were made using the Movement Specific Reinvestment Scale. Symptomatic participants followed the same data collection protocol (n=24) however, five breast support conditions were included: Usual, PFB, PFB28,and an Alternative Bra in the immediate term (AB) and after four weeks wear (AB28) (Optifit, Saddleworth, UK). A combination of clinical pain questionnaires measured symptomatic change.

RESULTS
All asymptomatic participants failed the bra fit assessment in the Usual bra and 67% (n=16) in the PFB. Less bra fit issues were present in the PFB compared to the usual bra, resulting in biomechanical changes relating to breast support and posture. These changes were not maintained over time (PFB28). All symptomatic participants (n=24) failed the bra fit assessment in the Usual bra, 87.5% (n=21) in the PFBs, and 4.2% (n=1) in the AB. The PFBs and ABs resulted in symptomatic relief; the ABs improved a greater number of clinical measures than the PFB. Biomechanically the AB maintained uplift over time through reduced Nipple-sternal-notch distance, whilst the PFB did not. Symptomatic relief may be associated to the resting position of the breast tissue on the anterior chest, rather than limiting dynamic breast movement or postural change.

DISCUSSION AND CONCLUSION
These findings suggest alternative measurement, sizing and fitting approaches, like the AB in this study, may provide clinical benefit for patients, and economic cost-saving for the NHS when implemented within a conservative pain management strategy amongst larger breasted women with NSBP. The potential wider benefits of improving bra fit for larger breasted women may include improved psychosocial wellbeing, empowerment of women to take control of a chronic condition and
reducing barriers to physical activity, all of which warrant further exploration.