Shoulder pain is a common complaint during pregnancy, reported by 6% to 8% of pregnant people. This discomfort can range from mild aches to more pronounced pain and often resolves after childbirth.
Common Reasons for Shoulder Pain During Pregnancy
Physiological changes contribute to shoulder pain during pregnancy. Increased hormone levels, particularly relaxin, loosen ligaments throughout the body, including the shoulders. This ligament laxity can lead to instability and muscle strain.
As pregnancy progresses, the body’s center of gravity shifts forward due to the growing abdomen. This postural adjustment can cause rounded shoulders and a curved upper back, straining the neck, shoulders, and upper back muscles. The added weight of a growing baby and breast enlargement further contributes to this strain, pulling shoulders forward. Difficulty finding comfortable sleeping positions, especially sleeping on one side without proper support, can also lead to shoulder strain. Physical and emotional stress can also manifest as muscle tension in the neck and shoulders.
When Shoulder Pain Signals a Serious Issue
While most shoulder pain during pregnancy is due to normal physiological changes, certain symptoms require immediate medical attention. Sudden, severe shoulder tip pain, where the shoulder meets the arm, can signal a ruptured ectopic pregnancy. This occurs when an embryo implants outside the uterus, often in the fallopian tube. The pain results from internal bleeding irritating the diaphragm, which refers pain to the shoulder, and may be accompanied by vaginal bleeding, lower back pain, or abdominal cramping.
Shoulder pain can also be a symptom of preeclampsia, a serious pregnancy complication characterized by high blood pressure. If shoulder pain accompanies a severe, persistent headache, vision changes, shortness of breath, right-sided upper abdominal pain, nausea, vomiting, or swelling in the hands and face, seek prompt medical care. Less commonly, pain radiating to the right shoulder blade can indicate gallbladder problems, which may worsen during pregnancy.
Increased risk of blood clots during pregnancy means shoulder pain, especially with shortness of breath, chest pain, or arm swelling, could indicate a pulmonary embolism. This requires urgent medical evaluation. Any severe, sudden pain or weakness in the shoulder, or if accompanied by fever, chills, severe abdominal pain, vaginal bleeding, dizziness, or fainting, warrants immediate medical consultation.
Strategies for Managing Shoulder Discomfort
For common shoulder discomfort not indicative of a serious condition, several strategies can provide relief. Maintaining proper posture while sitting, standing, and lifting reduces strain on the shoulders and upper back. Physical therapists can guide ergonomic solutions and proper body mechanics. Gentle exercises and stretches, such as scapular squeezes or shoulder rolls, improve flexibility, reduce tension, and strengthen supporting muscles. Activities like swimming and yoga also strengthen these muscle groups.
Applying heat or cold therapy manages pain and muscle tension. Warm compresses or heating pads increase blood flow and relax tight muscles, while ice packs reduce inflammation and numb the area. When using heat, ensure the temperature is warm, not hot, and limit application to 15-20 minutes, avoiding direct application to the abdomen. Supportive pillows, like pregnancy pillows, help align the neck, shoulders, and spine during sleep, reducing strain. Placing a pillow between the knees and ankles also aids spinal alignment.
Maternity support garments alleviate strain by supporting the growing belly and improving posture. Over-the-counter pain relievers like acetaminophen are generally safe during pregnancy, but consult a doctor before taking any medication. Professional help from physical therapists, chiropractors, or massage therapists experienced in prenatal care offers targeted relief through manual therapy, tailored exercises, and postural correction. Adequate rest and stress reduction techniques, such as mindful relaxation, are also important as stress can contribute to muscle tension.