Shoulder Pain in Pregnancy: Your Guide to Causes, Relief, and When to Worry

Shoulder pain is a surprisingly common complaint during pregnancy, joining the ranks of backaches and swollen feet. For most, it's just another part of the incredible journey your body is on. However, this ache can sometimes be a source of anxiety, as it can, in rare cases, signal a more serious health issue.

Understanding the difference between a normal muscular strain and a potential warning sign is key to your peace of mind and well-being. This comprehensive guide will walk you through the various causes of shoulder pain by trimester, help you identify red flags, and provide safe, effective strategies for relief.

Is Shoulder Pain Normal During Pregnancy?

Yes, for up to 50% of expectant mothers, shoulder pain is a normal part of pregnancy. The discomfort typically falls into two categories:

1. Musculoskeletal Pain: This is the most common type, caused directly by the physical and hormonal changes your body is undergoing. It usually feels like stiffness, soreness, or a dull ache.
2. Referred Pain: This is pain that you feel in your shoulder but originates from a problem elsewhere in your body. This type of pain is less common but can be a sign of a serious medical condition that needs immediate attention.

Let's break down the common, musculoskeletal causes you might experience in each stage of your pregnancy.

Common Causes of Shoulder Pain Throughout Pregnancy

Your body is a marvel of adaptation during pregnancy, but these changes can lead to new aches and pains.

First Trimester

Even before your bump starts to show, your body is hard at work. The hormone relaxin begins to surge, loosening ligaments and joints throughout your body to prepare for childbirth. While its main job is in the pelvis, relaxin affects all connective tissues, which can lead to instability and aches in unexpected places, including your shoulders.

Second Trimester

As your baby grows, your center of gravity shifts forward. This causes significant postural changes that can strain your upper body.

• Postural Strain: You may start to round your shoulders or lean back to compensate for the weight of your growing belly. This puts extra stress on the muscles in your neck, upper back, and shoulders.
• Increased Weight: The added weight of your baby, placenta, and increased blood volume puts more pressure on your entire musculoskeletal system.
• Sleeping Position: As you're encouraged to sleep on your side, you might find yourself in awkward positions that strain your shoulder joint, especially if you're not used to it.

!A diagram showing the postural changes during pregnancy, with one silhouette showing a neutral spine and another showing the S-curve and forward-rounding shoulders common in later pregnancy.

Third Trimester

In the final stretch, the physical changes become more pronounced. Your spine often develops a more significant "S" curve to handle the baby's weight, which can further strain your shoulder and back muscles. The continued effects of relaxin, combined with the challenge of finding a comfortable position for any activity, can make shoulder pain a persistent issue.

When Shoulder Pain Is a Serious Warning Sign

While most shoulder pain is benign, it's crucial to be aware of symptoms that could indicate a medical emergency. This type of "referred pain" is distinct from a simple muscle ache.

Ectopic Pregnancy: A First-Trimester Emergency

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. It is not a viable pregnancy and can be life-threatening if left untreated.

• What the Shoulder Pain Feels Like: The key symptom is a sudden, sharp pain specifically at the tip of your shoulder—where your arm and shoulder meet. This is caused by internal bleeding from a ruptured fallopian tube, which irritates a nerve connected to your diaphragm. The brain interprets this irritation as pain in the shoulder.
• Other Critical Symptoms: This shoulder tip pain rarely occurs alone. Seek emergency medical care immediately if you experience it alongside:
  • Severe, one-sided abdominal or pelvic pain
  • Vaginal bleeding or a watery, brown discharge
  • Feeling dizzy, faint, or weak
  • Pain during bowel movements or urination

Reference: The Ectopic Pregnancy Trust provides detailed information on identifying symptoms, including the specific nature of shoulder tip pain. Ectopic Pregnancy Signs And Symptoms

Preeclampsia: A Serious Condition After 20 Weeks

Preeclampsia is a high blood pressure disorder that can occur during the second half of pregnancy or even postpartum. It can lead to serious complications for both mother and baby.

• What the Shoulder Pain Feels Like: Preeclampsia can cause pain in the right shoulder. This pain is often described as a deep, pinching sensation that radiates from the upper right abdomen, just under the ribs. This is due to liver swelling, which irritates the surrounding nerves. The pain may worsen when you breathe deeply or lie on your right side.
• Other Key Symptoms: Be on high alert for shoulder pain accompanied by any other signs of preeclampsia:
  • A severe headache that won't go away
  • Vision changes, like seeing spots, flashing lights, or blurriness
  • Sudden swelling in your face and hands
  • Shortness of breath
  • Nausea or vomiting in the second half of pregnancy

Reference: The Preeclampsia Foundation explains that this pain is often called “referred pain” because it radiates from the liver. Signs and Symptoms of Preeclampsia

Other Potential Causes

• Gallstones: Pregnancy hormones can increase your risk of developing gallstones. A blockage can cause sudden, severe pain in your upper right abdomen that radiates to your right shoulder blade.
• Parsonage-Turner Syndrome (PTS): This is a rare disorder affecting the nerves that can cause intense, sudden pain in one shoulder, followed by weakness.

Safe and Effective Ways to Manage Common Shoulder Pain

For the more common musculoskeletal pain, you don't have to just endure it. There are many safe ways to find relief.

1. Focus on Your Posture

Be mindful of how you sit, stand, and walk. Try to keep your shoulders relaxed and back, avoiding the tendency to slump forward. When sitting, ensure your lower back is supported.

2. Gentle Stretches and Exercises

Gentle movement can relieve tension and strengthen the muscles supporting your shoulders.

• Shoulder Rolls: Sit or stand tall and slowly roll your shoulders up toward your ears, then back and down. Repeat 10 times in both directions.
• Cat-Cow Stretch: On your hands and knees, inhale as you drop your belly and look up (Cow). Exhale as you round your spine and tuck your chin (Cat). This mobilizes the entire spine.
• Swimming and Prenatal Yoga: These low-impact activities are excellent for strengthening your upper body and improving flexibility safely.

3. Improve Your Sleep Support

Finding a comfortable sleeping position can be a game-changer.

• Use a Pregnancy Pillow: A full-body pillow can provide support for your belly, back, and hips, keeping your spine aligned and taking pressure off your shoulders. Place part of the pillow between your knees to align your hips.

Image Source: Business Insider

4. Try At-Home Remedies

• Heat or Cold Therapy: A warm compress or a warm bath can help relax tight, sore muscles. An ice pack can help reduce inflammation.
• Prenatal Massage: A massage from a therapist certified in prenatal techniques can be a wonderful way to relieve muscle tension.
• Safe Pain Relief: Acetaminophen (Tylenol) is generally considered safe for occasional use during pregnancy, but always consult your doctor before taking any medication.

When to Call Your Doctor Immediately

Never hesitate to contact your healthcare provider if you are concerned. Seek immediate medical attention if you experience shoulder pain along with any of the following symptoms:

• Sudden, sharp, or severe pain, especially at the tip of your shoulder.
• Pain accompanied by vaginal bleeding, severe abdominal pain, dizziness, or fainting.
• Pain accompanied by severe headache, vision changes, or sudden swelling.
• Difficulty breathing or chest pain.

Your health and your baby's health are the top priority. It is always better to be cautious and seek medical advice if something doesn't feel right.

References

1. Healthline. (2020). Shoulder Pain in Pregnancy: Ectopic or Normal? https://www.healthline.com/health/pregnancy/shoulder-pain-pregnancy
2. Medical News Today. (2024). What to know about shoulder pain in pregnancy. https://www.medicalnewstoday.com/articles/shoulder-pain-pregnancy
3. The Ectopic Pregnancy Trust. Ectopic Pregnancy Signs And Symptoms. https://ectopic.org.uk/ectopic-pregnancy-symptoms
4. Preeclampsia Foundation. Signs and Symptoms of Preeclampsia. https://www.preeclampsia.org/signs-and-symptoms
5. NHS. (n.d.). Ectopic pregnancy - Symptoms. https://www.nhs.uk/conditions/ectopic-pregnancy/symptoms/
6. Hinge Health. (2025). If You Have Shoulder Pain During Pregnancy, Try This. https://www.hingehealth.com/resources/articles/shoulder-pain-pregnancy/
7. Boughtwood, S. (2025). Shoulder Pain in Pregnancy. Sarah Boughtwood Osteopath. https://www.sarahboughtwoodosteopath.co.nz/blog/why-are-my-shoulders-sore-in-pregnancy

---

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.