Managing Shoulder Pain During Pregnancy: Causes, Remedies, and When to Seek Medical Attention

What Are the Causes of Shoulder Pain During Pregnancy?

Pregnancy is a transformative journey that brings about numerous changes in a woman’s body. While these changes are often accompanied by discomfort, such as fatigue and abdominal sensations, it may come as a surprise that shoulder pain can also be directly linked to pregnancy. While shoulder pain during pregnancy is usually normal, there are cases where it may signify an underlying issue. Understanding the causes and appropriate actions to take is crucial when experiencing shoulder pain during pregnancy.

Common Causes of Shoulder Pain in Pregnancy

Shoulder pain during pregnancy can occur at any time and can stem from various factors. In most cases, it is considered normal and is attributed to changes in muscles and joints. Common causes of shoulder pain during pregnancy include:

1. Muscle and joint changes: Pregnancy brings about hormonal and physiological changes that affect the muscles and joints. These changes can lead to shoulder pain, particularly due to straining the back, poor posture, sleeping in awkward positions, and prolonged periods of standing.

2. Relaxin hormone: Even before conception, the body produces a hormone called relaxin. This hormone plays multiple roles throughout pregnancy, aiding in the growth and adaptation of the body for the developing baby. However, relaxin also loosens the connective tissues, which can result in aches and pains in various areas, including the shoulders.

To better understand the causes of shoulder pain during pregnancy, it’s essential to examine each trimester individually.

First Trimester

During the first trimester, the body begins producing relaxin, which starts affecting the muscles and joints. Shoulder pain experienced in the first trimester is often a result of the loosening connective tissue caused by relaxin. The pain may manifest as stiffness or mild achiness and is typically not severe or stabbing.

Second Trimester

As the baby grows, the body undergoes significant changes to accommodate the developing life. These changes include physical alterations in body shape, weight distribution, and posture, impacting everyday activities such as sleeping, sitting, standing, and walking. Research has shown that pregnant individuals in their second trimester have a slower gait (walking speed) compared to non-pregnant individuals. These bodily adjustments can lead to muscle aches, including shoulder pain.

Third Trimester

The third trimester brings further significant changes as the body prepares for childbirth. One notable change is the adaptation of the spine to carry the extra weight of the baby and other necessary elements. Research comparing the spines of pregnant women in their third trimester to non-pregnant women revealed a more curved lumbar spine in the pregnant group. This spinal curve, resembling an “S” shape, aids in supporting the increased weight during pregnancy. Consequently, alterations in the spine affect the back and shoulder muscles, potentially causing normal shoulder pain and aches.

Additionally, relaxin continues to relax the ligaments, including those in the shoulder joint, to facilitate the opening of the pelvic bone joints for delivery. Combined with changes in posture, sleep position, and gait, the relaxation of the shoulder joint can contribute to shoulder pain during the third trimester.

In summary, shoulder pain during pregnancy is a common occurrence caused by various factors related to the physiological changes taking place in the body. Understanding the causes specific to each trimester allows pregnant individuals to differentiate between normal discomfort and potential complications. While most shoulder pain during pregnancy is benign, it is always advisable to consult a healthcare professional to ensure the well-being of both the mother and baby.

More Serious Causes of Shoulder Pain in Pregnancy

While most cases of shoulder pain during pregnancy are normal and benign, it is essential to be aware of more serious causes that may require immediate medical attention. If you experience shoulder pain or any other unusual symptoms, it is crucial to inform your doctor for proper evaluation and guidance. The following are more serious causes of shoulder pain during pregnancy:

First Trimester

1. Ectopic or tubal pregnancy: If you experience shoulder pain early in the first trimester, it could be a sign of an ectopic or tubal pregnancy. This occurs when the embryo implants outside the uterus, usually in the Fallopian tube. Symptoms of an ectopic pregnancy typically occur between weeks 4 and 12 of pregnancy and may include:

   • Shoulder tip pain: A sudden, unusual pain between the shoulder and arm, which occurs due to bleeding in the abdomen. This bleeding irritates the nerve responsible for the involuntary muscles that move the diaphragm, leading to referred pain in the shoulder.

   • Other associated symptoms: Stomach pain, faintness, nausea or vomiting, vaginal bleeding, stomach bloating or fullness, pain during bowel movements, diarrhea, cramping or pain on one side.

   An ectopic pregnancy requires immediate medical attention.

Second and Third Trimesters

1. Gallstones: The hormones involved in pregnancy can occasionally lead to gallstones. If a gallstone becomes stuck in a duct or tube, it can cause severe symptoms. Shoulder pain on the right side during pregnancy may indicate gallstones. Additional symptoms may include:

   • Nausea and vomiting
   • Severe pain in the upper right abdomen that worsens
   • Sudden pain in the middle of the abdomen that worsens
   • Back pain between the shoulder blades

   Gallstones can be treated with lifestyle changes, such as regular meals, a fiber-rich diet, avoidance of fried and sugary foods, simple carbs, and light daily exercise. Surgery may be necessary for serious blockages or complications.

2. Preeclampsia: Shoulder pain can be a symptom of preeclampsia, a serious condition characterized by high blood pressure and other complications during pregnancy or after delivery. Preeclampsia symptoms typically manifest after week 20 of pregnancy, but they can occur earlier. Additional signs of preeclampsia include:

   • Facial swelling
   • Swelling of the hands
   • Headache pain
   • Changes in vision (blurred vision, seeing spots, sensitivity to light)
   • Pain when breathing deeply
   • Pain in the upper abdomen or upper right side
   • Nausea and vomiting
   • Shortness of breath or difficulty breathing

   Treatment for preeclampsia involves regular blood pressure monitoring, frequent doctor checkups, medication, a low-sodium diet, and bed rest to manage blood pressure. In severe cases, early delivery of the baby may be recommended. Most individuals recover shortly after childbirth.

It is crucial to consult with your healthcare provider if you experience any of these serious causes of shoulder pain during pregnancy to ensure appropriate management and care.

How to Relieve Common Causes of Shoulder Pain During Pregnancy

To alleviate common causes of shoulder pain during pregnancy, there are various strategies and remedies you can try. By implementing the following tips, you may find relief from shoulder pain:

1. Stretches: Perform gentle stretching exercises to relieve tension in your muscles and improve flexibility.

2. Massages: Seek the services of a practitioner knowledgeable about pregnancy to receive safe and effective massages.

3. Warm Baths: Take warm baths, ensuring the water is not too hot, to relax your muscles and ease discomfort.

4. Warm or Cold Compresses: Apply warm or cold compresses to the affected shoulder to reduce inflammation and alleviate pain.

5. Posture Support: Maintain good posture throughout the day to minimize strain on your muscles and joints. Consider using a posture support brace or belt.

6. Sleeping Support Pillow: Use a specially designed pregnancy pillow to provide support and align your body while sleeping. There are several options available, such as full-body pillows or wedges.

7. Pain Medication: Consult your doctor regarding safe pain medication options during pregnancy. Acetaminophen (Tylenol) is generally considered safe for occasional use.

It is important to note that for more serious causes of shoulder pain, such as ectopic pregnancy, gallstones, or preeclampsia, specific medical treatment from your doctor is required.

When to Call a Doctor

It is essential to contact your doctor if you experience any unusual or new symptoms during pregnancy, including severe shoulder pain that persists. Additionally:

1. Ectopic Pregnancy: If you suspect an ectopic pregnancy or experience severe, sharp pain, contact your doctor immediately. This condition may require emergency treatment or surgery to prevent complications.

2. Preeclampsia: If you have nausea and vomiting or other symptoms associated with preeclampsia during the second or third trimester, reach out to your doctor promptly.

Preventing Shoulder Pain in Pregnancy

While it may not be possible to prevent most aches and pains during pregnancy, there are steps you can take to minimize the risk of serious complications like preeclampsia. Discuss the following approaches with your doctor to help control your blood pressure during pregnancy:

1. Stay Hydrated: Drink plenty of water daily to maintain proper hydration.

2. Reduce Salt Intake: Limit your consumption of salt to help regulate blood pressure.

3. Increase Protein Intake: Include more protein-rich foods in your diet to support overall health and blood pressure management.

4. Elevate Your Feet: Take breaks to elevate your feet whenever possible to reduce swelling and improve circulation.

5. Avoid Prolonged Standing: Limit prolonged periods of standing to prevent excess strain on your body.

6. Engage in Light Exercise: Participate in regular light exercise, such as walking or prenatal yoga, to promote blood flow and overall well-being.

7. Avoid Fast Food and Fried Food: Minimize the consumption of fast food and fried foods, as they can contribute to high blood pressure.

The Bottom Line

Experiencing shoulder pain during pregnancy is not uncommon, and it is often attributed to mild causes that pose no harm. However, certain rare causes, such as ectopic pregnancy in the early first trimester and preeclampsia in the second or third trimester, can be concerning. If you encounter sudden, severe, or unusual pain, it is important to promptly consult your healthcare provider. Trust your instincts and inform your doctor about any symptoms that feel abnormal to ensure the best care for you and your baby during pregnancy.