Pregnancy can come with a lot of aches and pains that are often a normal part of the baby-making process. But while you probably expect sore feet, or a sore back, you may experience pain in one area of your body that surprises you: your shoulders. It might seem unexpected — after all, your shoulders are a little far away from all the action. But about six to eight percent of women report shoulder pain as part of their pregnancy symptoms.

The good news is there’s a lot you can do at home, with gentle exercises and stretches, to feel better. Shoulder pain during pregnancy also usually resolves once your baby’s born. But that doesn’t mean you have to wait for relief. 

Read on to find out more about why shoulder pain occurs during pregnancy and how to treat it, especially with exercises from our Hinge Health physical therapists. 

Causes of Shoulder Pain During Pregnancy

Here are some of the most common reasons you may experience shoulder pain during pregnancy:

• Increase in relaxin. Your body produces more of a hormone called relaxin during pregnancy. Why? It’s to help loosen pelvic ligaments in order to prepare the body for childbirth. But it doesn’t just target the pelvis, it relaxes all of the ligaments in your body, including your shoulder ligaments. This can cause muscle strain and pain. In fact, research has found a link between higher relaxin levels and a greater chance of developing shoulder instability.

• Posture changes. When you’re pregnant, your center of gravity moves forward. “As your breasts enlarge with pregnancy, your shoulders are pulled forward and rounded,” explains Sarah Kellen, PT, DPT, a physical therapist at Hinge Health. Over time, this can cause strain and shoulder pain even in early pregnancy.

• Lifting differently. As your little one grows, it can become harder to lift or carry things. You may find that you need to carry things on your side instead of in front of you. In some cases, this may add strain on your shoulders. 

Other Causes of Shoulder Pain During Pregnancy

Most of the time, shoulder pain is due to musculoskeletal pain and is nothing to worry about, reassures Dr. Kellen, but it’s worth mentioning to your doctor. You should also be mindful of the following symptoms, which could indicate a potentially more serious condition:

• Ectopic Pregnancy: Pain that’s localized at the tip of your shoulder (where it meets your arm) can be a sign of ectopic pregnancy if it’s accompanied by vaginal bleeding, lower back pain, and abdominal cramping.

• Preeclampsia: Shoulder pain that’s accompanied by severe headache that won't go away, changes in vision, shortness of breath, right sided upper abdominal pain (usually under the ribs), nausea/vomiting, or swelling in hands and face, could be a sign of preeclampsia. Preeclampsia is a serious pregnancy complication characterized by high blood pressure.

• Gallstones: Pain between your shoulder blades could be a sign of gallstones, especially if it’s accompanied by abdominal pain and vomiting. Gallstones tend to be more common among pregnant women.

If you notice any of the above symptoms, don’t panic, and don’t ask Dr. Google. Just call your physician and they’ll let you know what your next steps should be.

How to Relieve Shoulder Pain During Pregnancy

There’s a lot you can do to relieve shoulder aches and pains during pregnancy. These include:

• Exercise therapy. If you notice shoulder pain during pregnancy, you may be tempted to limit upper body movement. But just like during any other part of life, movement is medicine during pregnancy too, says Dr. Kellen. Focus on exercises that strengthen your shoulder and upper back muscles (see below). This will take pressure off your shoulder joints and help to relieve pain. Activities like swimming and yoga can also help to strengthen the muscles around your shoulders and relieve discomfort.

• Physical therapy. A physical therapist (PT) can guide you through stabilizing and strengthening exercises for your shoulder and upper back muscles. These will help make your shoulder joint more stable and address your pain. 

• Heat. A hot water bottle or warm shower will increase blood flow to the affected shoulder, which can help relax tight shoulder muscles.

• Over-the-counter-pain relievers. Acetaminophen (Tylenol) has been shown to be safe to use during pregnancy. Always check with your doctor before you use it.

• Massage. It may help loosen tight muscles, says Dr. Kellen. Just make sure you get doctor approval first, and that you find a therapist experienced with prenatal massage. Acupuncture has also been shown to be safe during pregnancy, and may help relieve shoulder pain.

How Physical Therapy Helps

“Physical therapy is a first-line treatment for shoulder pain during pregnancy, since so much of the discomfort is musculoskeletal,” says Dr. Kellen. “Our goal is to get your shoulder and upper back muscles moving and stronger to provide more support to your shoulder joints. Once we do that, pain will naturally decrease.”

During physical therapy, a PT can assess your movement patterns. “We want to see how you walk, lift, and carry things,” explains Dr. Kellen. “There may be ways to tweak these movements to make it easier on your shoulder muscles and joints during pregnancy.” A PT will also look for other muscle weaknesses in your upper body and core that may contribute to extra stress being placed on your shoulders. “Once we understand how your body and muscles are functioning, we can customize a strengthening and stretching program that you can do at home,” says Dr. Kellen. 

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Some exercises they may recommend can be found below.

These exercises are recommended by Hinge Health physical therapists to help relieve shoulder pain during pregnancy. They help to stretch and strengthen tight shoulder muscles which may feel overworked as your body adjusts to pregnancy-related changes.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Prevention 

Whether you’re prone to shoulder pain or just want to be proactive, there are things you can do to help prevent shoulder pain in pregnancy. Hinge Health physical therapists recommend:

• Staying active. Movement is key during pregnancy. While it may be hard to do your usual running or spinning workouts, swimming, water aerobics, walking, and prenatal yoga are all great options, says Dr. Kellen. These will all also help to strengthen shoulder muscles and prevent pain.

• Plumping up your sleeping position. If you’re pregnant, your doctor may often recommend that you sleep on your side (and you may find that’s the most comfortable position, anyway). You can place a pillow under your head for good neck support and a smaller pillow under the top arm when lying on your side. “These will support your shoulders and take pressure off as you sleep,” Dr. Kellen explains.

• Staying at a healthy weight. Pregnancy comes with weight gain. And while this may look a little different for everyone, gaining too much — or too little — weight can put strain on your shoulders. Talk to your doctor about what’s a healthy weight gain range for you.

• Wearing shoulder straps. Adjustable shoulder straps, worn alone or as part of a belly band, can provide upper back and shoulder support.

PT Tip: Don’t Forget Your Movement Snacks 

Movement snacks during the day can be very helpful for shoulder pain, especially when pregnant. “I recommend patients do exercises like the scapular squeezes periodically throughout the day,” says Dr. Kellen. “It helps to keep the front of the chest open, and strengthens your back and shoulders. It takes just a minute or two and is an easy way to prevent shoulder pain in pregnancy.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. 

Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Bermas, B. L. (2023, December 11). Maternal adaptations to pregnancy: Musculoskeletal changes and pain. UpToDate. https://www.uptodate.com/contents/maternal-adaptations-to-pregnancy-musculoskeletal-changes-and-pain 

2. Owens, B. D., Cameron, K. L., Clifton, K. B., Svoboda, S. J., & Wolf, J. M. (2016). Association Between Serum Relaxin and Subsequent Shoulder Instability. Orthopedics, 39(4). doi:10.3928/01477447-20160421-01

3. Kesikburun, S., Güzelküçük, Ü., Fidan, U., Demir, Y., Ergün, A., & Tan, A. K. (2018). Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Therapeutic Advances in Musculoskeletal Disease, 10(12), 229–234. doi:10.1177/1759720x18812449

4. Soliday, E., & Betts, D. (2018). Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. Journal of Acupuncture and Meridian Studies, 11(1), 25–30. doi:10.1016/j.jams.2017.11.005