For the case with the pain referring to the back, I wanted to suggest that the problem could be aggravated by something going on in the back, or even be originating in the back.  After being married to someone with fibromyalgia (me) for a quarter century, my physician ex-husband learned to look at the possibility of referred pain that had been fooling people, and found some interesting cases.  It is quite amazing how pain can radiate and make it seem that it is originating in a totally different area that one might think.    

It makes sense that there could be pain in the back after feeds or pumps, because we tend to be sitting it one position, often holding shoulders or arms up, even without realizing it, while nursing or pumping.  I would suggest that, along with the attempts to explain the pain as originating in the breast, this mom try some simple things, like making sure that her arms, shoulders and baby are supported with pillows, and relaxed (or that she is supporting the pump horns on the breast without holding her arms up).  It would be good if she could be reminded to reevaluate her body every five minutes or so, take a deep breath, and try to relax as much as possible.  Having her legs and hips comfortable is important, too.  In addition, some gentle stretching, massage, heat, or ice on the back can help too.  If trigger points can be located, injections of lidocaine (not steroids), given with no bigger than a 27 gauge needle (preferably 30) may be very helpful, too.  

Best Wishes,
Darillyn

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