The medical term for joint pain is arthralgia but most of the time the pain is due to inflammation of the joints which is known as arthritis. While arthritis can affect any person of any age, including males and children, it tends to be more common in certain situations. Joint pain in pregnancy is one such instance and it occurs for various reasons. Sometimes this pain may be a flare up of arthritis that existed prior to pregnancy while at other times the joint pain is only related to pregnancy itself and resolves after childbirth.
Pregnancy Strains the Joints
There are several reasons why pregnancy can impact on the joints and lead to joint pain. However, it is important to note that these reasons may not apply to every pregnant woman and also depends on the stage of pregnancy in question.
Body Weight Gain
The most obvious reason why joint pain arises in pregnancy is due to the mechanical strain that occurs with the weight gain. Women who experience a moderate weight gain may therefore not strain the joints to the same extent as a woman who gains excessive weight in pregnancy. Furthermore, a person’s body weight before falling pregnant is also a factor to consider. If a woman was overweight or obese prior to falling pregnant, the additional pregnancy weight gain can be the ‘tipping point’ for excessive strain on the joint. This tends to affect the weight-bearing joints to a greater degree, such as the hips, knees and ankles as well as the joints of the spine.
Center of Gravity Change
Another reason why the joints may be strained in pregnancy is with the resulting change in the center of gravity. The forward and upward shift of a pregnant woman’s center of gravity places strain on the back joints, which are not accustomed to this shift. It is further exacerbated by attempts to counteract this shift by arching backwards. The arching also places strain on the hip, knee and ankle joints due to the way the force is distributed downwards to the ground. It can also strain the joints between the bones of the feet.
Pregnancy Hormones and the Joints
The joints are made up of several parts, the main one being the cartilage between the opposing bones. In addition, ligaments and connective tissue provides support and stability to the joints. However, the hormonal changes associated with pregnancy can lead to laxity of the joint and supporting structures. This is due to well known hormones like estrogen but also lesser known hormones like relaxin which is secreted by the ovary, placenta and breast. It can lead to joint instability which may place additional strain on the joint and make it prone to injuries.
Does Pregnancy Cause Arthritis?
Joint inflammation can arise with strain and injuries which may therefore lead to pain. This inflammation is known as arthritis and is usually acute. It often eases after pregnancy. However, it is important to understand that this type of arthritis is not the same as the two common types of chronic arthritis, namely rheumatoid arthritis (RA) and osteoarthritis (OA).
Pregnancy does not cause rheumatoid arthritis which is joint inflammation that arises when the immune system attacks the joint lining. In fact pregnancy may actually lead to rheumatoid arthritis easing during pregnancy. The physiological changes in pregnancy alters immune activity in a way that may not only ease rheumatoid arthritis but even lead to a remission. However, this is not permanent and the joint inflammation usually returns after childbirth.
Osteoarthritis is usually associated with the elderly as the symptoms start becoming more prominent after the age of 60 years. However, the joint wear and tear occurs throughout life and degradation can start as early as the thirties although these are usually no symptoms at this age. Nevertheless the strain on the joints can worsen osteoarthritis as the wear and tear on the joint intensifies especially in late pregnancy. However, this may not be noticeable in pregnancy unless there is joint injury or when it occurs in older women who may fall pregnant.
Post-traumatic arthritis is a result of joint injury, as may occur with falls. Given the change in center of gravity which can impair balance and the consequences of other changes in the pregnant body, injuries like falls are more likely to occur. This can then lead to joint injuries and result in post-traumatic arthritis.
How to Prevent Joint Pain in Pregnancy?
There is no definitive way of preventing joint pain in pregancy as the physiologic changes of pregnancy cannot be avoided. It is never advisable to attempt to counteract these changes by means of dieting or exercising excessibely during pregnancy to avoid weight gain for example. However, a few simple lifestyle measures can help ease the strain on the joints and therefore ease the joint pain to some degree.
- Do not use high heel shoes. While most pregnant women avoid these type of shoes, it is important to realize that even a short period of wearing heels can lead to significant joint strain.
- Elevate the legs when sitting. This not only helps with circulation but places less strain that may arise with bending of the legs at the knees.
- Reduce walking and standing. It is not necessary to be sedentary entirely. In fact being moderately active is advisable in pregnancy but do not overdo it. Do not stand for long periods or walk for long distances.
- Remember RICE. In the event that the was extra stress on the joint or a joint injury, rest (R), ice (I), compression (C) and elevation (E) helps to limit the inflammation.
- Use a joint brace. A range of soft braces for joint support are available commercially. This can help provide support to weak and strained joints but should not be applied too tightly as it can affect blood circulation through the leg.
- Never use balms or rubs. Always get a doctor’s permission before using most commercially available balms and rubs for joint aches and muscle pains. Some of these applications may contain ingredients that are contraindicated in pregnancy.