If you’re pregnant you know that all the new, exciting changes in your body come with a few hiccups. Some of these include being tired a lot of the time and feeling aches, butterflies, and tingles in your belly and back.
Pregnancy can also cause pain in parts of the body that seem pretty far removed from where all the action is taking place. You might be surprised to learn that your new shoulder pain may be directly linked to your pregnancy.
Shoulder pain (like other aches) can be normal in pregnancy. But, in some cases, shoulder pain — along with other symptoms — might be a sign that something’s not quite right. When in your pregnancy you have shoulder pain is important.
Here’s what to know and what to do if you have shoulder pain during pregnancy.
Shoulder pain during pregnancy can happen at any time, and for many reasons. Most of the time, it’s normal.
It happens due to changes to your muscles and joints. Causes can include straining your back, sleeping in a funny position, not having good posture, and standing for too long.
Typical (and non-worrisome) shoulder pain during pregnancy might feel like stiffness or achiness. It shouldn’t feel like severe or stabbing pain.
First trimester
Your body makes a hormone called relaxin even before you get pregnant. This hormone also has lots of different jobs from the beginning of pregnancy to the birth of your baby. Relaxin helps your body grow and change for your developing little one.
Essentially, relaxin does this by loosening your connective tissue, which can cause aches and pains in various places — including your shoulders.
Second trimester
As your baby grows, so does your body in order to nourish this new blossoming life. In the second trimester, your baby bump begins to show and your body shape and weight changes for a healthy pregnancy.
The changes in your body impact how you’re sleeping, sitting, standing and even walking. In fact, one small medical study found that those in their second trimester had a slower gait (walking speed) than people who weren’t pregnant.
This means that even though you may not look very pregnant yet, the changes in your body are affecting your muscles and how you carry yourself. This can lead to muscles aches, including shoulder pain.
Third trimester
In the third trimester, you obviously have lots of changes in your body as your little one gets ready to make their entrance. Your body adapts to carrying around a baby and a mini portable nursery in many ways — including literally curving your spine!
In the same 2015 study as above, researchers compared the spines of 19 pregnant women in their third trimester to women who weren’t pregnant. They found that the lumbar (lower end) of the spine in the pregnant women in their third trimester was more curved.
This means that your spine looks more like an “S” later in pregnancy to help handle the extra pounds of baby, food, blood, and more. The changes in your spine can lead to changes in your back and shoulder muscles. This may lead to normal shoulder pain and aches during pregnancy.
Also in the third trimester, relaxin continues to help relax your ligaments so that your pelvic bone joints can loosen up and open to better deliver your baby. Other joints in your body also loosen up, including your shoulder joints.
Relaxing the shoulder joint, along with changes to your posture, sleep position, how you walk, and everything else can lead to normal shoulder pain during the third trimester.
More serious causes of shoulder pain can happen at any time during your pregnancy, too. That’s why you should let your doctor know if you have shoulder pain or any other unusual symptoms.
First trimester
If you feel pain in your shoulder very early in your first trimester, the cause might be an ectopic or tubal pregnancy. This is when the embryo implant outside the uterus — usually in the Fallopian tube.
People with an ectopic pregnancy typically have symptoms between weeks 4 and 12 of pregnancy. You might have symptoms before you even know you’re pregnant or before you’ve seen your doctor.
An ectopic pregnancy may cause shoulder tip pain. This may feel like a sudden, strange pain just between your shoulder and arm.
This serious cause of shoulder pain in pregnancy actually happens because there is bleeding in the abdomen. This bleeding can’t be seen, but it can irritate the nerve responsible for the involuntary muscles that move the diaphragm.
In turn, the nerve transmits sensory information from the diaphragm and the shoulder region, creating the perception of pain — referred pain — in the shoulder.
You’ll likely have other symptoms along with the shoulder pain, like:
- 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
Gallstones
The hormones that help you get and stay pregnant can also cause side effects — including, in rare instances, gallstones. You might not know you have gallstones at all, but if a gallstone gets stuck in a duct or tube, it can cause serious symptoms.
Pain in your right shoulder during pregnancy might mean that you have gallstones. Other symptoms include:
- nausea and vomiting
- severe pain in your upper right abdomen that gets worse
- sudden pain in the middle of your abdomen that gets worse
- back pain between your shoulder blades
Pain from gallstones can last for minutes or even hours. In serious cases, you may have a high fever and even jaundice (yellowing of the skin and eyes).
You might need surgery to remove the gallstones if you have a serious blockage or other complications. But in most cases, gallstones can be treated with lifestyle changes, like:
- eating regular meals
- adding more fiber-rich foods to your diet
- avoiding fried foods
- avoiding sugary foods
- avoiding simple carbs
- getting light exercise every day
Preeclampsia
In the second or third trimester, shoulder pain may be one of the symptoms of preeclampsia. This serious condition happens when you have high blood pressure (hypertension) and other complications during pregnancy or after your delivery.
Symptoms usually happen after week 20 of pregnancy, but they can happen earlier. Aside from shoulder pain, other signs of preeclampsia include:
- face swelling
- swelling of the hands
- headache pain
- changes in vision
- blurred vision or seeing spots
- sensitivity to light
- pain when breathing in deeply
- pain in the upper abdomen
- pain on the upper right side
- nausea and vomiting
- shortness of breath or difficulty breathing
Treatment for preeclampsia includes checking your blood pressure several times a day and seeing your doctor for regular checkups. You may need medication, a low-sodium diet, and bed rest to help control your blood pressure.
If your preeclampsia symptoms don’t improve, your doctor may recommend delivering your baby early. You’ll typically recover shortly after having your baby.
You should be able to treat standard pregnancy aches and pains — including shoulder pain — with a few tips and tricks. You should feel better with:
- stretches
- massages — just try to see a practitioner who’s knowledgeable about pregnancy
- a warm (not hot) bath
- warm or cold compresses
- posture support
- sleeping support pillow — here are some good options
Ask your doctor about which pain medication is safe during pregnancy and right for you. Acetaminophen (Tylenol) is normally OK to take occasionally.
For more serious causes of shoulder pain — ectopic, gallstones, and preeclampsia — you’ll need more specific medical treatment from your doctor.
Always reach out to your doctor if you have any unusual, new, or strange symptoms during pregnancy — including severe shoulder pain or pain that doesn’t get better.
Call your doctor and get urgent medical care if you think you might have an ectopic pregnancy or if you feel any kind of severe, sharp pain. You may need emergency treatment or even surgery to help prevent harmful complications from an ectopic pregnancy.
Call your doctor right away if you have nausea and vomiting or other symptoms of preeclampsia during your second or third trimester.
You won’t be able to prevent most aches and pains during pregnancy. Occasional shoulder pain is a normal part of pregnancy.
But you may be able to help prevent serious complications like preeclampsia. Talk to your doctor about the best ways for you to control your blood pressure during pregnancy.
Tips to balance your blood pressure during pregnancy include:
- drinking plenty of water every day
- reducing salt in your diet
- adding more protein to your diet
- putting your feet up when you can
- avoiding standing for too long
- getting light exercise everyday
- avoiding fast food
- avoiding fried food
It’s not uncommon to have shoulder pain while you’re pregnant — and it can happen for several, mild reasons throughout your pregnancy.
There are a few rare causes of shoulder pain that can be harmful. These include an ectopic pregnancy early in the first trimester and preeclampsia during your second or third trimester.
Always check with your healthcare provider right away if you have sudden, strange, or severe pain. Tell your doctor about any symptoms that don’t feel “normal.” You know your body better than anyone else — even when pregnant!