Shoulder pain during pregnancy can be a normal reaction to changing hormones in a woman’s body, or it can be a sign of a more serious problem, such as an ectopic pregnancy, gallstones or preeclampsia. Careful monitoring of your symptoms at various stages of your pregnancy can help you determine when shoulder pain needs more intensive medical treatment.
The same hormones that relax the body’s muscles, tendons and ligaments in preparation for the birth of a baby can cause shoulder pain and poor function. You can take a number of actions to reduce shoulder discomfort while ensuring that your shoulder pain does not signal a more serious health matter is occurring.
Anatomy and Physiology of the Shoulder
Structure and function of the shoulder joint
The shoulder is a complex ball and socket joint that provides 180 degrees of movement. The joint is made up of three bones the upper arm bone, called the humerus, the shoulder blade, called the scapula, and the collarbone, called the clavicle. The rounded head of the humerus fits into a cup-like socket in the shoulder blade. A number of muscles and tendon, called the rotator cuff, holds these bones in place. This combination of bones, muscles and tendons provides a wide range of movement for the arm.
Role of ligaments, tendons, and muscles in shoulder movement
The smooth interaction of ligaments, tendons and muscles are critical effective arm and shoulder movement. An injury or dysfunction in any one of the structures that hold the shoulder bones together can lead to pain, stiffness, poor range of motion or complete inability to put weight on the shoulder joint.
Pregnancy-Related Changes in the Body
Hormonal changes affecting ligaments and joints
From the earliest days, pregnancy causes numerous hormonal changes that are designed to prepare the woman’s body for carrying a child to term and giving birth. These changes include the production of progesterone and a hormone called relaxin, which loosens joints and muscles in the body in preparation for birth. These physical changes can lead to a variety of aches and pains throughout the body.
Increased weight and pressure on the shoulders
The increased weight and blood volume that occurs during pregnancy can lead to increased pressure on the upper back and shoulder joint and can cause discomfort and poor function.
Common Causes of Shoulder Pain During Pregnancy
Poor posture and muscle imbalances
Shoulder pain can occur during the first trimester of pregnancy because you may sleep more than usual, which can cause muscle imbalances. You may sleep in an awkward position, which can lead to shoulder pain. In the second trimester, the changes in your body can affect the way you walk, sit and move, which can cause posture changes that lead to shoulder pain. In the third trimester, the weight of the growing fetus can cause changes in spinal curvature that can radiate to shoulder pain.
Ectopic pregnancy complications
Although the shoulder is distant from the pelvis where the pregnancy is occurring, an ectopic pregnancy, that is, when a fertilized egg does not travel normally through the fallopian tubes to be implanted in the uterus, can cause shoulder pain. This generally occurs as a result of bleeding in the fallopian tube from the growing embryo, which causes referred pain in the shoulder.
Overuse or strain from daily activities
Preparing for the birth of a child can be a busy time of preparation. Women often develop strains of the shoulder from nursery painting, furniture assembly and other tasks.
Pressure on nerves or blood vessels
A nerve within the diaphragm connects directly to the shoulder. Pressure from the growing fetus can compress nerves or blood vessels, causing shoulder pain.
Understanding Ectopic Pregnancies
Definition and causes of ectopic pregnancies
An ectopic pregnancy is one in which the fertilized egg fails to move down the fallopian tubes to implant in the uterine wall in a normal fashion. Instead, the egg remains in the fallopian tube or other pelvic organ and continues to grow there, causing a medical emergency for the woman. An ectopic pregnancy may occur due to scarring in the fallopian tube from previous pelvic surgery, from a growth blocking the tube, from damage from a sexually transmitted disease or from genetic malformations of the fallopian tubes.
Impact on fallopian tubes and potential for shoulder pain
Fallopian tubes are not designed to be flexible to accommodate a growing embryo, as the uterus is. The growing embryo causes the fallopian tube to stretch, which could lead to rupture. The increased pressure and possible bleeding of the fallopian tube can affect a nerve that leads to the shoulder, which can cause pain in the joint.
Ways to minimize shoulder strain during pregnancy
1. Maintain good posture.
Good posture is even more important during pregnancy. Continue an approved exercise regime to keep muscles, tendons and ligaments strong. Be alert to your posture when standing or sitting to prevent muscle strain or pinched nerves.
Sleep on your side with a pillow between your knees and either a pregnancy pillow or pillows under your head/neck and between arms. This takes pressure off the shoulders.
Simple actions to support your body more effectively during sleep can help to reduce shoulder discomfort and other minor strains from spending hours in awkward positions. Try different types of pillows to provide the most comfortable positioning during the night.
2. Avoid carrying heavy objects with arms stretched out in front of you.
Hold items close to the body at chest level when lifting. Ask for help moving very heavy items.
Poor lifting and carrying technique can put undue strain on back muscles and shoulder muscles during pregnancy. Because hormones during pregnancy tend to relax structures in the body, carrying heavy loads can cause increased strain on muscles. Getting help to do heavy tasks can help to reduce the risk of injury.
3. Do posture exercises like shoulder rolls, chest opens and wall angels to strengthen back muscles and counteract forward shoulder positioning.
Yes, regular exercise targeted for the upper body can help to reduce strain and risk of injury to the shoulder.
4. Consider supportive braces and bands to improve alignment, posture, and take pressure off shoulder joints.
You can find a number of different types of back braces and bands that help to support muscles of the back and shoulders that can be beneficial for reducing discomfort during pregnancy.
5. Apply hot or cold therapy to aching muscles for temporary relief of muscle tightness and pain.
The standard home remedy for muscle pain and stiffness is the R.I.C.E. method. Rest the muscles to allow faster healing. Apply ice packs to reduce inflammation in the muscle. Compression with an elastic bandage or brace can help to support the area. You can also elevate the area to reduce swelling.
6. Get massages focusing on the upper back region
Massage is a natural, drug-free method of reducing discomfort and improving healing of tissues in the back and upper shoulders.
7. Perform gentle, low-impact cardio to increase blood flow and relax tense muscles
Regular exercise helps to improve blood flow and strengthen muscles during pregnancy. However, limit exercise to low impact cardio to avoid injury to your changing body.
8. Evaluate your work setup ergonomics
Ergonomic changes in your work environment can help to reduce pressure and strain on muscles and nerves. Take note of whether your work chair provides good support for your lower back. Are items conveniently located around the desk area to reduce bending and twisting motions? Is lighting adequate to prevent bending and straining to see? If you stand frequently during the day, do you have a pressure-reducing mat or flooring that reduces fatigue?
8. Consider seeing a chiropractor or physical therapist.
Chiropractic deals with the musculoskeletal system of the human body and how it functions together for effective movement. Chiropractors provide treatment for a number of muscle, spine and joint problems and can be helpful during pregnancy to relieve common issues. A physical therapist focuses on particular parts of the body and can help to strengthen muscles to relieve pain and improve function.
Frequently Asked Questions
Is shoulder pain normal in pregnancy?
Yes, shoulder pain is common in all stages of pregnancy, due to hormonal changes that occur and sometimes, because of medical issues.
Can pregnancy hormones cause shoulder pain?
Yes, hormones produced during pregnancy are designed to relax muscles and joints to accommodate the growing fetus and to prepare for birth. These hormones can lead to weakness and strain in the shoulders.
Which shoulder hurts with ectopic pregnancy?
Shoulder pain related to an ectopic pregnancy can occur on either the right or the left side, depending on which side of the body the fallopian tube is affected.
How to relieve shoulder pain?
Simple measures like rest, icing, compression and elevation can help to relieve shoulder discomfort. Bracing can also help to reduce pain. Massage, acupuncture, chiropractic care and physical therapy can also help to reduce shoulder pain.
Can pregnancy cause neck and shoulder pain?
Yes, hormonal changes during pregnancy that relax muscles can lead to neck and shoulder pain from ordinary actions.
When should I worry about shoulder pain in pregnancy?
Pain that is constant, is unrelieved by common home remedies and pain that is accompanied by other symptoms, such as cramping, bleeding, dizziness or shortness of breath should be seen by a medical professional.
Can pregnancy cause back and shoulder pain?
Yes, pregnancy can cause back and shoulder pain, due to a number of health issues that are common during the changing hormonal and physical conditions that can develop.
Is shoulder pain related to uterus?
A nerve in the diaphragm connects to the shoulder, which can be triggered by abdominal and pelvic changes during pregnancy.
Is shoulder and back pain normal in early pregnancy?
Yes, back and shoulder pain is common in early pregnancy as hormonal changes and fatigue can lead to weakness in this area of the body. .
What does left shoulder pain in a woman mean?
Left shoulder pain in a woman can be a minor problem, such as gas trapped in the chest cavity or straining a shoulder muscle. However, pain in the left shoulder can also be a sign of a heart attack. If pain is accompanied by sweating and severe fatigue, you should seek medical attention to determine if you are experiencing a heart attack.
Why do I have pain in my left shoulder?
Shoulder pain can stem from a number of causes, some minor and harmless, while others may be more serious. Left shoulder pain could result from muscle strain, which can occur due to increased relaxation of muscles from hormonal changes. Pain can also occur because of more serious problems such as heart issues, gallstones, or gastrointestinal problems related to pregnancy.
What week is the highest risk of miscarriage?
Miscarriage occurs most frequently in the 3rd and 4th weeks of pregnancy. Once past this period, the incidence of miscarriage drops significantly.
What are the warning signs of a miscarriage?
If you are having cramping or back pain, it could be a sign of impending miscarriage. Bleeding or pink mucus from the vagina could signal a miscarriage. Clots from the vagina is another sign. You may experience weight loss or the diminishment of other signs of pregnancy.
Can gas cause shoulder pain?
Yes, gas trapped in the upper abdominal cavity can radiate into the shoulder, causing pain.
What are 3 signs of an ectopic pregnancy?
The three most common signs of a possible ectopic pregnancy include abdominal or pelvic pain, vaginal bleeding and lightheadedness or fainting. In some cases, internal bleeding can cause shoulder pain.
What helps shoulder pain during pregnancy?
A number of remedies can help relieve shoulder pain during pregnancy. Pay attention to your sleep posture and use a pillow to prop your shoulder or to improve your back position during sleep. Ask for help from family or friends for reaching and lifting tasks. Ice packs can be effective for relieving shoulder muscle pain. Massage is another good way to relieve shoulder pain. Stretching and yoga can help to keep muscles primed and flexible. If shoulder pain becomes chronic, see a chiropractor or physical therapist for additional treatment.
What week does ectopic pain start?
Pain from an ectopic pregnancy can begin as early as 4 weeks after your last period or as late as 10 weeks. Some ectopic pregnancies cause no pain and end naturally, expelling the fertilized egg on their own. However, any unusual symptoms of pain or bleeding should be referred to your doctor for investigation.
