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Spencer L1, McKenna L1, Fary R1, Briffa K1
1Curtin University, School of Physiotherapy and Exercise Science, Perth, Australia
Background: Upper back pain (UBP) is common in women with large breasts. In addition to UBP, women who are waiting reduction mammoplasty (RM) surgery, also report negative perceptions of wellbeing, body satisfaction, and physical activity levels. Factors related to bra fit are also problematic and women with larger breasts commonly wear incorrectly fitted and sized bras. Independent of breast size, and in those not awaiting RM surgery, little is known about how the perceptions of women with UBP differ from those without.
Purpose: To determine how perceptions of wellbeing, body satisfaction and physical activity levels were related to UBP status and UBP severity, independent of breast size and age in women who are not awaiting RM surgery.
Methods: A cross-sectional online questionnaire that collected self-report data from healthy postmenopausal women was used. Data collected included: breast size (bra size); upper back pain (UBP) status; UBP severity (Numerical Rating Scale); quality of life (SF-36); breast (BREAST-Q); body and bra fit satisfactions; and physical activity levels (Human Activity Profile). Logistic regression examined between group differences, based on UBP status. The association of each characteristic with UBP (yes/no) was estimated using odds ratios (OR) with associated 95% confidence intervals (95%CI). Each characteristic was then evaluated separately in a logistic regression model adjusted for
1) age and
2) age and breast size.
Linear regression analysis was used to assess the correlation (r) and univariate association (R2) of each characteristic with UBP severity (UBP NRS) in participants with UBP.
Results: 204 postmenopausal women participated in this study; 117 (57%) had UBP. Women with UBP were significantly younger, had a larger BMI and larger breasts. Independent of age and breast size, a greater sense of physical wellbeing (OR:0.88, 95%CI: 0.93-0.98); breast satisfaction (OR:0.97, 95%CI:0.95-0.99); body satisfaction (OR: 0.77, 95%CI:0.66-0.90); bra fit satisfaction (OR:2.24, 95%CI:1.22-4.12) and higher levels of physical activity (OR:0.96, 95%CI: 0.93-0.98) were associated with a significant decrease in odds for UBP. Dissatisfaction with bra fit increased the odds for UBP (OR: 2.24, 95%CI: 1.22-4.12) whereas having a bra professionally fitted, was not associated with UBP. The severity of UBP was correlated with physical activity levels (r=-0.26, p=.004); physical wellbeing (r=-0.33, p= .001) and mental wellbeing (r=-0.19, p=.043). Physical wellbeing accounted for 11% of the explained variance in UBP severity.
Conclusion(s): Breast size may increase the risk for UBP but after accounting for this risk and differences in age, women with UBP are less physically active and perceive their wellbeing and satisfaction related to their body and breasts more negatively. The severity of UBP is independent of differences in breast size and age but is associated with differences in physical and mental wellbeing and physical activity levels. Future research might assess the efficacy of conservative interventions targeting physical activity; perceptions of wellbeing and satisfactions in reducing UBP in postmenopausal women.
Implications: Clinicians treating postmenopausal women with UBP could consider modifying physical activity levels, perceptions of wellbeing and satisfactions of these women.
Keywords: Upper back pain, Breast size, Wellbeing
Funding acknowledgements: Primary researcher supported by funding from an Australian Government Research Training Program Scholarship and Curtin University Research Scholarship.
Purpose: To determine how perceptions of wellbeing, body satisfaction and physical activity levels were related to UBP status and UBP severity, independent of breast size and age in women who are not awaiting RM surgery.
Methods: A cross-sectional online questionnaire that collected self-report data from healthy postmenopausal women was used. Data collected included: breast size (bra size); upper back pain (UBP) status; UBP severity (Numerical Rating Scale); quality of life (SF-36); breast (BREAST-Q); body and bra fit satisfactions; and physical activity levels (Human Activity Profile). Logistic regression examined between group differences, based on UBP status. The association of each characteristic with UBP (yes/no) was estimated using odds ratios (OR) with associated 95% confidence intervals (95%CI). Each characteristic was then evaluated separately in a logistic regression model adjusted for
1) age and
2) age and breast size.
Linear regression analysis was used to assess the correlation (r) and univariate association (R2) of each characteristic with UBP severity (UBP NRS) in participants with UBP.
Results: 204 postmenopausal women participated in this study; 117 (57%) had UBP. Women with UBP were significantly younger, had a larger BMI and larger breasts. Independent of age and breast size, a greater sense of physical wellbeing (OR:0.88, 95%CI: 0.93-0.98); breast satisfaction (OR:0.97, 95%CI:0.95-0.99); body satisfaction (OR: 0.77, 95%CI:0.66-0.90); bra fit satisfaction (OR:2.24, 95%CI:1.22-4.12) and higher levels of physical activity (OR:0.96, 95%CI: 0.93-0.98) were associated with a significant decrease in odds for UBP. Dissatisfaction with bra fit increased the odds for UBP (OR: 2.24, 95%CI: 1.22-4.12) whereas having a bra professionally fitted, was not associated with UBP. The severity of UBP was correlated with physical activity levels (r=-0.26, p=.004); physical wellbeing (r=-0.33, p= .001) and mental wellbeing (r=-0.19, p=.043). Physical wellbeing accounted for 11% of the explained variance in UBP severity.
Conclusion(s): Breast size may increase the risk for UBP but after accounting for this risk and differences in age, women with UBP are less physically active and perceive their wellbeing and satisfaction related to their body and breasts more negatively. The severity of UBP is independent of differences in breast size and age but is associated with differences in physical and mental wellbeing and physical activity levels. Future research might assess the efficacy of conservative interventions targeting physical activity; perceptions of wellbeing and satisfactions in reducing UBP in postmenopausal women.
Implications: Clinicians treating postmenopausal women with UBP could consider modifying physical activity levels, perceptions of wellbeing and satisfactions of these women.
Keywords: Upper back pain, Breast size, Wellbeing
Funding acknowledgements: Primary researcher supported by funding from an Australian Government Research Training Program Scholarship and Curtin University Research Scholarship.
Topic: Pain & pain management; Health promotion & wellbeing/healthy ageing; Musculoskeletal: spine
Ethics approval required: Yes
Institution: Curtin University
Ethics committee: Human Research Ethics Committee
Ethics number: RDHS-267-15
All authors, affiliations and abstracts have been published as submitted.
