Joint pain (arthralgia) during pregnancy and after childbirth is quite a common occurrence and is caused mainly due to the hormonal changes that come about during pregnancy. Even normal weight gain in pregnant women can put additional strain on the joints and cause varying amount of discomfort or even pain. A change in the center of gravity caused by the weight of the growing baby in the uterus, results in a change in the posture and gait of a pregnant woman which often contributes to joint pains.
Although pelvic pain, including low back pain and hip joint pain are encountered most frequently during pregnancy, other joints may also be affected, such as the knee joint, ankle and wrist.
What Causes Joint Pain during and after Pregnancy?
A number of factors may be related to causing joint pain during and after pregnancy.
Obstetric Causes of Joint Pain
- Pregnancy hormones, such as relaxin, help to relax the joints of the pelvis by relaxing the muscles and ligaments around the joint, so as to facilitate easy delivery of the baby through the birth canal. Excessive relaxation, however, may weaken the joints and result in pain. Although relaxin works mainly on the pelvic joints, it does have some effect on the other joints as well.
- Pregnancy Weight Gain
- This can cause more stress on the joints, particularly those related to weight-bearing. Changes in body weight distribution and posture as a result of carrying the weight of the growing fetus will also contribute to joint pain.
- Swelling caused by fluid retention in pregnancy may lead to conditions like carpal tunnel syndrome.
- Nutritional Deficiencies
- Deficiencies of nutrients, especially of DHA or docosahexaenoic acid (an essential fatty acid present abundantly in fish such as tuna and salmon, which helps in lubrication of the joints) can be a cause of joint pain during and after pregnancy.
- Emotional Stress and Physical Strain
- The stress and strain following delivery of the baby as well as feeding and caring for a newborn baby can lead to pain in various joints.
- Non-specific joint pain is also reported frequently in post-partum depression (PPD)
Non-obstetric Causes of Joint Pain
Refer to Joint Pain Causes for a list of reasons for joint pain that may not be related to pregnancy and can affect a single join or multiple joints.
Causes of Joint Pain during and after Pregnancy
Pelvic Joint Pain
- Pelvic Joint Instability
- The two hip bones on either side are attached to the symphysis pubis in front and the sacrum at the back by means of ligaments and cartilage.
- Some amount of laxity of the joints due to relaxin is common during pregnancy.
- If, however, there is excessive laxity it may result in pelvic joint instability which may cause significant pain in the joints.
- After delivery of the baby, most women recover from this type of pain but some women continue to suffer even after childbirth.
- It may recur in consecutive pregnancies in spite of being pain-free in between.
- Symphysis Pubic Dysfunction (SPD)
- Many pregnant women suffer from this type of pelvic joint pain, commonly occurring from the second trimester onwards, although it may occur any time during pregnancy and may even persist after delivery of the baby.
- Low back pain and hip joint pain may be associated with pain in the groin, inner thigh or pubic area.
- Climbing stairs or moving the legs apart may cause exacerbation of pain, which may be accompanied by a clicking or grinding sensation.
- Similar pain may occur in subsequent pregnancies.
- Diastasis Symphysis Pubis (DSP)
- This condition is related to SPD but occurs less frequently.
- The gap of 4 to 5 mm that normally occurs between the two pubic bones may widen by another 2 to 3 mm during pregnancy.
- Further stretching, with a gap of 10 mm or more may result in pain that can become quite severe.
Also refer to Pelvic Pain in Pregnancy for other causes of pain in the pelvis that may not be related to the joints.
Sacroiliac Joint Pain
Sacroiliac Joint Dysfunction
The sacroiliac joint is a stable joint formed by the sacrum at the back and the two iliac bones (which form the pelvis) on either side. The sacroiliac joints connect the spine to the pelvis and is a major weight bearing joint. Relaxation of this joint may occur during pregnancy and cause low back pain, made worse on putting pressure on one leg, such as while climbing stairs or getting out of the car.
Knee Joint Pain
Weight gain during pregnancy may cause excessive stress on weight bearing joints such as the knee joint and result in pain.
Ankle Joint Pain
Ankle joints may be similarly affected as the knee joint due to pregnancy weight gain.
Wrist Joint Pain
Carpal tunnel syndrome is compression of the median nerve as it passes through the carpal tunnel in the wrist formed by the wrist bones below and the covering ligament on top. It is quite common during pregnancy, caused mainly by fluid retention and swelling at the wrist. Tingling, numbness and pain in the area supplied by the median nerve (thumb, index, middle and half of ring finger and part of the palm) may be some of the symptoms, which can become quite severe. However, the symptoms are usually relieved after the birth of the baby.