Shoulder blade pain early pregnancy

Shoulder Pain in Pregnancy: Ectopic or Normal?

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!

Is Shoulder Pain a Sign of Pregnancy?

There are many changes that occur in a pregnant woman’s body, some expected and some unexpected. Pregnancy neck pain and shoulder blade pain are some of the lesser-known symptoms that pregnant women can experience. 

Please continue reading to find out why a pregnant woman may experience neck and shoulder pain. Also, find out when to seek emergency medical care for shoulder pain during pregnancy.

Yes, it’s possible to have shoulder pain during early pregnancy. This can happen for many reasons. Most of the time, it’s not something to worry about. However, sometimes shoulder pain during pregnancy can be a symptom of a more serious condition. It may even be a medical emergency for which you need to seek medical attention right away. 

Shoulder pain during pregnancy can occur due to:

• Poor posture while sitting and standing
• Odd sleeping posture
• Back and neck pain that is referred to the shoulders
• Release of a hormone called relaxin which loosens connective tissue and ligaments, causing such symptoms as aches and pains throughout the body
• Changes in the muscles and joints, including muscle stiffness
• Changes in the curvature of the lumbar, thoracic, and cervical spine as the body adapts to carrying a baby

Shoulder pain during pregnancy that feels achy or stiff is likely nothing to worry about. However, if you have sudden severe or stabbing pain, you should see a healthcare professional right away.  

Shoulder tip pain can be a sign of ectopic pregnancy. This pain can feel like a sudden strange, or unusual pain right where the shoulder ends and the arm begins. The pain can be either left or right shoulder pain. It can also be present in both shoulders. 

Ectopic pregnancies occur when a fertilized egg implants outside the usual location in the uterus, such as in the fallopian tubes. Also called a tubal pregnancy, this is a serious problem that is potentially life-threatening. It requires immediate medical attention. You need to see a doctor immediately to have the pregnancy medically reviewed.

The reason for shoulder pain in an ectopic pregnancy is internal bleeding in the abdomen. This bleeding can irritate a nerve that supplies the diaphragm, a major breathing muscle located below the lungs called the diaphragm. The pain originates in the diaphragm, but pain signals can be transmitted to the shoulder, causing referred pain in the shoulder joint.  

Besides pain in the shoulder, other symptoms may include abdominal pain, cramping on one side, nausea, vomiting, diarrhea, pain with bowel movements, bloating, fainting, and vaginal bleeding. Signs and symptoms of an ectopic pregnancy usually occur during early pregnancy, between 4 and 12 weeks.

Other conditions can cause shoulder pain in pregnant women as the pregnancy progresses, such as gallstones. During the second trimester or third trimester, pregnancy hormones can cause the formation of gallstones in rare cases. If a gallstone blocks a duct, it can cause symptoms such as fever, nausea, vomiting, severe pain in the upper abdomen, and pain in the upper back between the shoulder blades.

Another potential cause of shoulder pain during the second and third trimesters is preeclampsia. This is a serious condition that occurs in pregnant women who have hypertension (high blood pressure). Other symptoms of preeclampsia can include swelling of the face and hands, headache, vision changes, light sensitivity, stomach pain, nausea, vomiting, and difficulty breathing.

Pregnant women may not be able to completely prevent shoulder pain. However, should pain may benefit from stretching, massage therapy, warm (not hot) baths, correct posture, and a pregnancy support pillow for sleeping.

If you want to take a medication to reduce pain, make sure you ask your healthcare provider about which pain reliever is safe during pregnancy. It is usually okay to take acetaminophen (Tylenol) occasionally.

More serious causes of shoulder pain during pregnancy include ectopic pregnancy, gallstones, and preeclampsia. These conditions require specific medical treatment from a healthcare professional. Contact your doctor without delay if you have any of the signs and symptoms of these serious complications or severe pain in your shoulder.
 

References:

1. https://www.nhs.uk/conditions/ectopic-pregnancy/symptoms/
2. https://www.jstage.jst.go.jp/article/jpts/27/1/27_jpts-2014-437/_article/-char/ja/

causes of pain in the early stages and in the second trimester

From the moment of conception, the woman's body is rebuilt. The composition of the produced hormones changes, nutrients are distributed between the mother and the fetus. At an early stage, these changes are invisible to others. But the woman notices that menstruation did not begin at the appointed time. Taste preferences change, nausea appears in the morning, fatigue, drowsiness, irritability or unusual peace. If you notice signs of pregnancy, you need to see a doctor. A few days after the delay in menstruation, pregnancy can be confirmed by laboratory tests. The doctor will give advice on how to prevent the development of pathologies and bear a healthy child. nine0003

At the first appointment, the doctor will warn you about early symptoms that indicate a threat of miscarriage:

frequent vomiting - more than three times a day.

Lower back pain may occur during the first trimester of pregnancy. It is often encountered by women in the later stages. It arises due to increased weight and a shift in the center of gravity. But in the first trimester, the weight and size of the abdomen change slightly. You need to analyze your condition and understand if there is a danger. nine0003

Causes that do not cause concern

Pulling the lower back during pregnancy can be due to various processes occurring in the body. Some of them create inconvenience, but do not pose a threat.

Attachment of the ovum to the uterus

Attachment of the ovum to the wall of the uterus occurs 5-7 days after fertilization, even before the woman notices a delay in menstruation and thinks about a possible pregnancy. The process may be accompanied by an increase in vaginal discharge. They are not white, but pink. Women often believe that menstruation begins. Due to the production of various hormones, a few days can pull the lower back. These sensations are caused by natural, not pathological changes in the body. They are harmless, do not require treatment and disappear after 5-6 days. nine0003

Changes in the circulatory system

After the attachment of the fetal egg in the uterus, the fetus begins to grow. He needs more nutrients and oxygen every day. To deliver them, the circulatory system begins to work differently, directing more blood to the uterus. Vessels from the pelvic area overflow, increase in volume and come into contact with the nerve endings in the lumbar region. There is a pulling pain. It is felt at 5-7 weeks of pregnancy. If the pain symptoms are not very pronounced, you can not worry. The body will rebuild, and the pain will pass without treatment. nine0003

Softening of the joints, ligaments

During childbirth, the joints and ligaments in the spine and pelvis should be well stretched. The body prepares in advance for the upcoming work. He already at an early stage begins to produce the hormone relaxin, which softens the joints and ligaments. Due to a change in their density, it can pull the lower back.

Uterine growth

At 9-10 weeks of pregnancy, the volume of the uterus already noticeably increases. The woman feels that the lower abdomen has become more firm and convex. The growing uterus begins to come into contact with other organs. With increased sensitivity, its pressure can be felt at an early stage. But more often women experience discomfort, mild pressing back pain in the second trimester. nine0003

Braxton-Higgs contractions

At the end of the first and beginning of the second trimester, spontaneous uterine contractions may occur, resembling labor pains, but less intense. Drawing cramping pain is given in the lower back. They can periodically disturb 2-3 weeks. If there are no other dangerous symptoms, medication, restriction of motor activity is not required.

Drawing back pain in pregnant women often occurs from natural causes. They do not pose a threat to the health of the expectant mother and the development of the fetus, do not require treatment. But it is necessary to tell the doctor about them in the antenatal clinic. He correlates them with other symptoms and will not miss the signs of an incipient miscarriage, other pathologies. nine0003

Dangerous conditions

Drawing pain in the lower back is often one of the signs of dangerous conditions:

• missed pregnancy, threatened miscarriage;
• diseases of the genitourinary system;
• osteochondrosis;
• symphysite;
• colds.

Missed pregnancy, threatened miscarriage

In case of missed pregnancy, threatened miscarriage, lower back pain is accompanied by bloody discharge from the vagina, cramping or constant aching pain in the lower abdomen. This is a dangerous condition. You need to immediately go to the hospital or call an ambulance. Do not refuse if the doctor suggests treatment in a hospital. To stop an incipient miscarriage, you need to administer drugs intravenously, limit physical activity, and constantly monitor the condition of the woman and fetus. nine0003

In case of miscarriage, examinations should be carried out to make sure that there are no particles of the fetus left in the uterus. This can cause a life-threatening inflammatory process or further infertility. Requires the introduction of drugs that enhance uterine contraction, relieve inflammation, or surgical intervention.

Diseases of the genitourinary system

Immunity in pregnant women is weakened. Hypothermia, malnutrition, increased stress can cause kidney disease. If the lower back is pulled during pregnancy on one side, on the right or on the left, check the functioning of the genitourinary system. Additional symptoms indicate problems with the kidneys: legs and arms swell, pressure and temperature rise, and pain occurs when urinating. Women with chronic kidney disease should be especially careful. They can worsen when the load on the diseased organ increases - in the second or third trimester, with a cold or eating salty, spicy, smoked, fatty foods. You cannot self-medicate. Taking the usual antibacterial drugs (Canephron, Levofloxacin, Furadonin) is undesirable for pregnant women. You need to see a nephrologist. He will prescribe a safe treatment. nine0003

Osteochondrosis

Starting from 7-8 weeks, the hormone relaxin begins to be produced, softening the joints and ligaments. If before conception a woman suffered from osteochondrosis, scoliosis, kyphosis, an exacerbation of diseases is possible even in the first or second trimester. An additional risk factor is rapid weight gain.

In women who have not previously suffered from osteochondrosis, it can develop in the later stages, when the spine is under a lot of stress due to a significant increase in body weight, a shift in the center of gravity, uterine pressure and softening of the joints and ligaments. The pain is pulling, exhausting, aggravated after a long stay in one position. With dystrophic tissue lesions, it can be felt on one side, left or right. Spinal problems can complicate childbirth. If you do not start treatment in a timely manner, do not engage in prevention, they will continue to progress after childbirth. nine0003

Symphysitis

If the production of the hormone relaxin is strongly activated, premature softening of the joints occurs, which can cause the pubic bones to diverge. This increases the risk of preterm birth. With the divergence of the pubic bones, the pain is shooting, sharp. She gives to the lower abdomen and lower back. There are swelling in the pubic area. To diagnose symphysitis, the doctor examines blood and urine tests, conducts an additional ultrasound examination, observes the dynamics of the development of the disease and decides on the possibility of natural childbirth or the need for a planned caesarean section. In the later stages, motor activity may be limited, strict bed rest is recommended. nine0003

Colds

Pregnancy increases the risk of complications from colds. Especially dangerous is the early period when the organs of the fetus are formed. A significant increase in temperature, infection, uncontrolled use of antibiotics can provoke serious pathologies.

It is necessary to consult a doctor and start treatment at the first symptoms of a cold. Lower back pain and body aches can occur when the temperature rises. It passes if it is knocked down using traditional medicine recommended by a doctor. But if it hurts in the lower back on the right or left, the temperature rises to 39degrees, there was a strong cough, shortness of breath - pneumonia is possible. You need to call a doctor at home or an ambulance.

Prevention and treatment

If you have pain in your lower back during pregnancy, do not take painkillers. If the pain is severe, but examinations have not shown dangerous pathologies, consult a doctor. After studying the causes and symptoms of pain, he will choose safe ways to alleviate the condition.

In the first trimester, you need to be especially careful. A woman may still not know about pregnancy, but pain is already appearing. With a delay in menstruation, even for 2-3 days, you need to coordinate drug treatment with your doctor. nine0003

The second trimester is the time when a woman intensively gains weight and the load on the musculoskeletal system increases, pressure on the internal organs. The doctor will advise you to wear a bandage for pregnant women and other non-drug ways to relieve and prevent pain.

The third trimester - the body prepares for childbirth, the joints soften, the bones in the pelvic area diverge. If it pulls the lower back, the lower abdomen hurts, you need to lie down. If the pain intensifies, becomes cramping, childbirth may begin. If the period is less than 38 weeks, call the doctor who manages the pregnancy and describe the symptoms. nine0003

Prevention of pain in the lower back

To reduce the risk of lower back pain, the development of diseases of the musculoskeletal system:

• do not lift heavy loads, in the early term, power loads can provoke a miscarriage, in the late term - premature birth;
• do not wear tight shoes, shoes and boots with high heels, they create an additional load on the spine;
• watch your weight, no need to eat "for two"; nine0008
• Eat more foods containing calcium, a mineral-vitamin complex recommended by your doctor;
• consult a doctor and start herbal medicine at the first sign of a cold, avoiding a significant increase in temperature;
• do not slouch, keep your back straight so that the load is distributed evenly;
• do not overwork, do not work for a long time in one position.

Keep fit. The muscular frame will reduce the load on the spine. Regular, but not too intense exercise, walks in the fresh air will strengthen the immune system, help control weight. Useful swimming in the pool or ponds with clean running water. Learn and regularly do a set of exercises for pregnant women. nine0003

5 Exercises for Back Pain During Pregnancy - Academic Medical Center (AMC)

During the second half of pregnancy, most women suffer from nagging lower back pain. Most often, it is caused by physiological changes in the body and disappears with a change in body position and the selection of a comfortable posture. Back pain can also be provoked by inflammatory and infectious diseases and exacerbations of chronic pathologies. To determine the cause of discomfort, be sure to consult a doctor. If no diseases have been identified, and aching pain is the result of an increase in the load on the back muscles, then special physical exercises will help to loosen it. nine0003

5 Back Relaxation Exercises