Pain guide · Shoulder pain

Shoulder pain in pregnancy: posture, the neck, sleeping on your side, and ectopic and other signs

Shoulder pain in pregnancy usually comes from the neck and shoulder muscles or the rotator cuff tendons: sleeping on your side later in pregnancy, long spells at a desk and, after the birth, feeding and carrying your baby. It affects a minority of women in each trimester and becomes more common after the birth. Gentle movement, sleeping on the side that doesn't hurt, and rotator cuff and shoulder-blade exercises help most, and either side is safe to sleep on.

A few signs need help straight away. Shoulder tip pain, where the shoulder ends and the arm begins, in early pregnancy can be a sign of an ectopic pregnancy bleeding inside: get medical advice right away, and call 999 with severe tummy pain, bleeding, dizziness or fainting. From 20 weeks and after the birth, bad pain under the right ribs can be pre-eclampsia: call your maternity unit, or the National Health Service's 111 line (NHS 111) after the birth. This guide covers how to tell the causes apart, sleep and feeding, safe painkillers, and a four-stage plan with 3D demos.

4-stage exercise plan When to get help 68 sourcesUpdated 27 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: if you are or could be pregnant, shoulder tip pain (where the shoulder ends and the arm begins) with sudden severe tummy pain, dizziness or fainting. It can mean bleeding from an ectopic pregnancy.
Call 999 or go to A&E immediately: a combination of a sharp, sudden and intense pain in your tummy, feeling very dizzy or fainting, feeling sick, or looking very pale, if there's any chance you could be pregnant. It could be an ectopic pregnancy that has split open (ruptured).
Call 999 if you're pregnant and bleeding and you have severe pain in your tummy, pain in your shoulder, you feel sick, faint or dizzy or pass out, or the bleeding is heavy (soaking a period pad soon after putting it on).
Contact your GP or call NHS 111 straight away: you might be pregnant, even without a positive pregnancy test, and you have a combination of tummy pain low down on one side, vaginal bleeding or a brown watery discharge, pain in the tip of your shoulder, or discomfort when peeing or pooing. It can be an ectopic pregnancy.
Get urgent medical help: you're pregnant or have given birth in the last few weeks and have symptoms of pre-eclampsia, such as pain below the ribs, a severe headache that does not go away with simple painkillers, vision problems such as blurred vision or seeing flashing lights, sudden swelling of the face, hands or feet, heartburn that does not go away with heartburn medicines, being sick, or feeling very unwell. If you're pregnant, call your maternity unit if you have the number; if you've recently given birth or cannot call your maternity unit, call 111.
Get help for any of these in pregnancy: vaginal bleeding, fluid leaking from your vagina, a change in your baby's movements, a high temperature, a severe headache, vision problems such as blurring or seeing flashing lights, or sudden swelling in your face, hands, legs or feet (vision problems and sudden swelling need checking immediately). In the first 12 weeks, contact your GP surgery or early pregnancy unit; from 12 to 19 weeks, your midwife or early pregnancy unit; from 20 weeks, your midwife or maternity unit. Always call 999 if you think it's a life-threatening emergency, and call NHS 111 if you're not sure what to do.
Call 999 or go to A&E: you have sudden, severe pain in your tummy; pain that spreads from your tummy to your back, and you're being sick; your temperature is very high, or you feel hot, cold or shivery; or your skin or the white part of your eyes looks yellow. These can be signs of a problem with gallstones.
Same day (urgent GP appointment or NHS 111): pain in your tummy, often in the middle or just under the ribs on the right, that lasts longer than 30 minutes; it may spread from there to your side or shoulder blade. It can be gallstones.
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. These are the NHS's signs of a blood clot in the lungs (a pulmonary embolism) or another serious condition. Don't drive yourself.
Get help straight away: breathlessness that comes on suddenly, that comes on when you lie down, or that comes with chest pain or dizziness. Feeling out of breath is common in pregnancy, but these need checking immediately.
Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Call 999: you suddenly can't fully lift both arms and keep them there, because of weakness or numbness in one arm, especially if one side of your face droops or you slur your words or sound confused. It could be a stroke. Call even if the signs have stopped.
Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
After a fall or a knock to your bump, even if you feel fine, call your maternity unit: they may want to check you and your baby. If you hit your head, call your GP or NHS 111 as well. This is our suggestion, from NHS Greater Glasgow and Clyde's and NHS Wales's maternity advice: the NHS website gives no tier for a fall in pregnancy.
Same day (GP or NHS 111): the shoulder or arm is hot, swollen or red, or you have a high temperature (although not everyone has one) or feel unwell. A joint infection needs same-day care.
Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
Numbness in both arms at the same time, dizziness, double vision or blackouts, an unusual, severe and persistent headache, legs giving way for no reason, or changes in your speech or swallowing: call your GP straight away or go to your nearest A&E department. This is the advice of POGP, the UK's pelvic and obstetric physiotherapists. Tingling in both hands at night is common in pregnancy and is usually carpal tunnel syndrome, not this.
In the hours or weeks after the birth: pain in the shoulder or arm that comes on strongly, followed days or weeks later by weakness in the arm or hand: ask for an urgent GP appointment or get help from NHS 111. It is rare, and most women recover well. Weakness with a drooping face or slurred speech is a 999 call (our suggestion, from a case series).

See a doctor or physiotherapist if

Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm. In many areas you can refer yourself to physiotherapy.
Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
Pins and needles that you have all the time, or that keep coming back: see a GP.
Tingling, numbness or an ache in the fingers or hand, often worse at night, that is getting worse or not going away, or isn't helped by a wrist splint: see a GP. It is more likely in pregnancy, and it can be carpal tunnel syndrome rather than the neck.
Neck, shoulder or back pain since having a baby that is bothering you: ask a GP or health visitor at any time, or raise it at your 6 to 8 week postnatal check.
Muscle and joint pain in pregnancy or after the birth that is bothering you: these problems are common, but they are not normal and should not be put up with in silence. Ask your GP or midwife to refer you to a specialist women's health physiotherapist (the pelvic and obstetric physiotherapists' advice).

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

An ache from the neck to the top of the shoulder after screens, feeds or a long day

Usually the neck and shoulder muscles. Our neck pain in pregnancy guide covers the neck, sleep and feeding positions.

Read: Neck pain in pregnancy →Pain on the outside of the upper arm, worse lifting overhead, reaching behind or lying on it

Usually the rotator cuff tendons, the commonest cause of shoulder pain. The arm moves fully if someone else lifts it. This guide's plan covers it, and our shoulder impingement guide goes further.

Read: Shoulder impingement (rotator cuff pain) →The shoulder hurts most at night, or when you lie on it

Lie on the side that doesn't hurt, with a pillow for the sore arm; either side is safe in pregnancy. Our shoulder pain at night guide covers sleeping set-ups for everyone.

Read: Shoulder pain at night →A deep ache, stiff in every direction, especially turning the arm out

Possibly a frozen shoulder, which is uncommon at pregnancy ages and most common between 45 and 60. Our frozen shoulder guide covers it.

Read: Frozen shoulder →Pain from the neck or shoulder blade down the arm, with pins and needles or burning

Possibly a nerve in the neck: shoulder pain can come from the neck even when the neck doesn't hurt.

Read: Pinched nerve in the neck →Tingling in the thumb and first fingers, worse at night or first thing

Usually carpal tunnel syndrome at the wrist, which about a third of pregnant women report. Our wrist pain in pregnancy guide covers it.

Read: Wrist pain in pregnancy →

Pain where the shoulder ends and the arm begins in early pregnancy, not brought on by moving the arm

Shoulder tip pain can be a sign of an ectopic pregnancy bleeding inside, especially with tummy pain low on one side, bleeding or dizziness: get advice straight away, as the warning signs say.

Bad or persistent pain under the right ribs, sometimes into the right shoulder, from 20 weeks or after the birth

This can be pre-eclampsia, or rarely HELLP syndrome: call your maternity unit, as the warning signs say. Our rib pain in pregnancy guide covers the ribs.

Read: Rib pain in pregnancy →

Severe pain under the right ribs for more than 30 minutes, often after a fatty meal, spreading to the shoulder blade

Possibly gallstones: get help the same day, as the warning signs say. In pregnancy, pain under the right ribs also needs your maternity unit.

Shoulder tip pain during or in the days after a caesarean

Common, and it usually settles within about 3 days. Heavy bleeding, feeling faint or breathlessness are warning signs.

Between the shoulder blades in pregnancy

Our back pain in pregnancy guide covers the upper back as well as the low back.

Read: Back pain in pregnancy →The front of the shoulder, worse reaching back or overhead

Our front of the shoulder pain guide sorts the causes.

Read: Front of shoulder pain →Shoulder pain at other times of life

Our shoulder pain in women guide covers the rotator cuff, frozen shoulder and the menopause.

Read: Shoulder pain in women →

Understand it

A minority of pregnant women, and no UK figuresEmerging evidence

In one Turkish hospital study of 184 women, 6.0% reported shoulder pain in the first trimester, 7.6% in the second and 8.2% in the third, with no clear rise late in pregnancy; about a third reported carpal tunnel symptoms. No study has made shoulder pain in pregnancy its main question, and there is no UK figure. In a survey of 1,651 Israeli women, back pain differences between pregnant and non-pregnant women disappeared once general health and other factors were allowed for (the shoulder wasn't reported in the summary we read).

The UK's pelvic and obstetric physiotherapists (POGP) say muscle and joint symptoms are most likely in the third trimester, can start earlier or carry on after the birth, and "In most cases symptoms will improve after you give birth".

Sources 1, 2, 3

Commoner after the birth, with feeding and carryingEmerging evidence

In 216 breastfeeding mothers at a Turkish clinic, 34.3% had shoulder pain, more with the cross-cradle hold; rocking the baby to sleep in the arms went with more arm and shoulder disability, and help at home with less. In an online survey of 471 mothers, about 3 in 10 named the shoulder, arm or hand as the painful area. In 308 Japanese women a month after the birth, most neck and shoulder pain was across the top of the shoulder, linked with time spent on each feed and tiredness, and in 2,413 Swedish women, neck and shoulder pain was common at 2 months and a year after the birth.

These are surveys, mostly outside the UK, which can't show cause.

Sources 4, 5, 6, 7

Why it happens: the neck, posture, joints and carryingEmerging evidence

"Occasionally, problems felt in your shoulder can be due to a neck problem. This can happen even when you don't feel pain in your neck", NHS inform says. POGP lists posture changes as the baby grows, more flexible joints, enlarged breasts, feeding in an awkward position and lifting and carrying after the birth.

The evidence for each is thin. Spinal curves change in pregnancy, but not consistently, and back pain didn't track the changes in a review of 50 papers; in adults who aren't pregnant, a rounded upper back wasn't linked with shoulder pain. No study has looked at shoulder looseness in pregnancy: wrist looseness rose in 19 of 35 pregnant women but didn't track relaxin, and the one study linking relaxin to shoulder instability was in young athletes who weren't pregnant. Front or back baby carriers load the wearer's body less than carrying a baby in your arms.

Sources 8, 3, 9, 10, 11, 12, 13

The rotator cuff and frozen shoulderStrong evidence

Rotator cuff (subacromial) pain is "the most common reason for shoulder pain", NHS inform says: pain in the upper arm when you lift it above shoulder level or reach behind your back, and it may be hard to lie on that side. The arm moves fully when someone else lifts it, which is how a clinician tells it from a frozen shoulder.

A frozen shoulder causes pain near the top of the arm and a large loss of turning the arm out. It typically affects women between 45 and 60, and diabetes is the strongest link (10.8% with diabetes against 2.3% without, in the British Elbow and Shoulder Society's pathway). No study links frozen shoulder or rotator cuff pain with pregnancy or gestational diabetes, so in pregnancy a frozen shoulder is likely to be uncommon.

Sources 14, 15, 16, 17, 18, 19

Causes that aren't the shoulder, and how rare they areStrong evidence

"Shoulder tip pain is an unusual pain felt where your shoulder ends and your arm begins", and it can be a sign of an ectopic pregnancy causing some internal bleeding, the NHS says. About 1 in 90 UK pregnancies is ectopic, with symptoms usually between the 4th and 12th week; ruptures are uncommon and treatable, and deaths from them are extremely rare in the UK.

Later in pregnancy, pain under the ribs that is "bad or persistent, particularly on the right side, ... can be a sign of pre-eclampsia", which usually starts after 20 weeks or just after the birth, the NHS says. HELLP syndrome, a rare liver and blood disorder linked with it, affects 0.5% to 0.9% of pregnancies, and acute fatty liver of pregnancy about 5 in 100,000. Gallstone pain sits under the right ribs and "may spread from here to your side or shoulder blade" (NHS inform); new gallbladder sludge or stones showed on scans in about 1 in 20 women by mid-pregnancy, and most gallstones cause no symptoms.

Clots affect only 1 to 2 in 1,000 women in pregnancy or the 6 weeks after, the Royal College of Obstetricians and Gynaecologists (RCOG) says. A heart attack in pregnancy or the week after is rarer still: 0.7 per 100,000 maternities in the UK.

Sources 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32

Where to get help, and how fastStrong evidence

Pelvic pain with pain in the tip of your shoulder, or bleeding in pregnancy with shoulder pain, is a 999 call, the NHS says. An inflamed gallbladder causes a sudden, sharp pain under the right ribs that "spreads towards your right shoulder". Heart pain can spread to either arm, the neck, jaw or shoulder, and sudden breathlessness with chest or upper back pain is a 999 call. A hot, swollen joint with a high temperature needs help the same day.

Otherwise, where to turn in pregnancy depends on how far along you are: your GP surgery or early pregnancy unit in the first 12 weeks, your midwife or early pregnancy unit from 12 to 19 weeks, and your midwife or maternity unit from 20 weeks. Call NHS 111 if you're not sure what to do.

Sources 33, 34, 35, 36, 37, 38, 39, 40

Shoulder tip pain after a caesarean is commonEmerging evidence

In 165 women having a planned caesarean under a spinal anaesthetic, 49.6% had shoulder tip pain during or after it, and a review says it usually settles within about 72 hours. Heavy bleeding, feeling faint or breathlessness are the warning signs, not the shoulder pain itself.

Sources 41, 42

When a scan or test helpsStrong evidence

Rotator cuff pain and frozen shoulder are diagnosed from the story and an examination, not a scan. An X-ray is for a fall or a suspected break or dislocation: tell the radiographer you're pregnant, and UK guidance says the dose to the baby from diagnostic X-rays "should present no risk", with ultrasound or MRI considered first where they would answer the question.

A suspected ectopic pregnancy needs a pregnancy test, then an ultrasound scan and blood tests; gallstones are found with an ultrasound scan and a blood test; and nerve tests for carpal tunnel "are not essential to make a diagnosis".

Sources 14, 17, 43, 44, 45, 21, 27, 46

How it usually goesEmerging evidence

Most muscle and joint symptoms of pregnancy improve after the birth (POGP). Rotator cuff pain "usually gets better in a few weeks or months", though "It can take 6 months or longer to recover from shoulder pain", the NHS says, and a frozen shoulder can take more than 2 years. Carpal tunnel often eases after the birth but can last a year or more. No one can promise a timescale.

Sources 3, 15, 47, 18, 48, 49

What helps, and how strong the evidence is

Exercise is the main treatment for rotator cuff pain, in adults who aren't pregnantStrong evidence

No trial has tested shoulder exercise in pregnancy. In 102 adults on a surgery waiting list, specific rotator cuff and shoulder-blade exercises (3 sets of 15, twice a day for 8 weeks) gave a successful outcome in 69% against 24% with general exercise, and only 20% chose surgery afterwards against 63%. In 708 adults with new rotator cuff pain, one session of best-practice advice with a home band programme did as well over a year as up to six physiotherapy sessions.

Shaving bone from the shoulder (decompression) did no better than placebo surgery in another large trial. The British Elbow and Shoulder Society's pathway puts exercise and physiotherapy first, usually for 6 weeks, with 6 more if it's helping.

Sources 50, 51, 16, 52

Sleep on your side, either sideStrong evidence

From 28 weeks, "The safest position to go to sleep is on your side, either left or right", the NHS says, and NICE suggests pillows to help you stay there. In pooled data from 851 late stillbirths and 2,257 controls, going to sleep on the right side was as safe as the left (adjusted odds ratio 1.04), so you can lie on the side that doesn't hurt.

Lying on a shoulder raises the pressure under the shoulder's roof in a lab study of 20 volunteers, but in 761 workers no sleeping position went with more shoulder pain. No study has tested side-lying and shoulder pain in pregnancy.

Sources 53, 54, 55, 56, 57

Exercise is safe in pregnancy, with a few changesStrong evidence

The UK Chief Medical Officers advise 150 minutes of moderate activity a week and muscle strengthening twice a week in pregnancy: "There is no evidence of harm". The NHS counts "carrying shopping and carrying children" as strength work, but says avoid lying flat on your back for more than a few minutes in later pregnancy, and sports with a risk of falling or bumping your tummy.

After the 6 to 8 week postnatal check, build from moderate to vigorous activity over at least 3 months, the Chief Medical Officers' report says.

Sources 58, 59, 60

Painkillers and injectionsMixed evidence

"If you're pregnant, paracetamol is usually the best painkiller to use", and "You should avoid using ibuprofen during pregnancy unless you're advised to by a doctor or pharmacist", the NHS says; the NHS frozen shoulder page's ibuprofen step is for adults generally. While breastfeeding, ibuprofen can often be used.

A steroid injection eased rotator cuff pain a little at 8 weeks and not at all by a year in the large trial, and "Injections won't cure your condition", NHS inform says. In pregnancy, one review found no harm reported from a single local steroid injection and says it should be judged case by case: a decision for you and your clinician, not a first step.

Sources 61, 62, 63, 51, 14, 64

Feeding, carrying and bras: comfort steps, lightly testedEmerging evidence

The NHS says get comfortable before a feed, with pillows if you need them and your shoulders and arms relaxed, and sit with your back supported. The cross-cradle hold went with more shoulder pain in one survey, support during feeds with less pain in another, and carriers load the body less than carrying in arms. POGP advises a supportive bra. None of these has been tested as a treatment for shoulder pain.

Sources 65, 66, 4, 5, 13, 3

Posture fixes and relaxin: overstatedEmerging evidence

Sitting tall is a comfort step, but a rounded upper back wasn't linked with shoulder pain in adults, and pregnancy posture changes vary from woman to woman. The idea that relaxin loosens the shoulders rests on a study of young athletes who weren't pregnant; in pregnancy, joint looseness didn't track relaxin.

Sources 9, 10, 11, 12

How much pain is OK while you exercise?

Up to 5 out of 10 while strengthening, back to normal by the next session, and tonight is the testEmerging evidence

This guide uses the shoulder hub's rule, from the Holmgren trial: during strengthening, pain up to 5 out of 10 is acceptable, and any rise should settle back to where it was before the next session; if it doesn't, use a lighter band or a smaller range next time. NHS inform's shoulder exercises use the same 0 to 5 band, and your pain "should be no worse the morning after you've exercised". For the gentle moves of the first stage, keep to 0 to 3 while night pain is constant (as our shoulder pain at night guide does).

Tonight is the test (borrowed from our shoulder pain at night guide): exercise pain should settle within a few hours and not disturb that night's sleep. In pregnancy, stop if you feel uncomfortable, too hot or unwell (the NHS), and "Listen to your body and adapt" (the Chief Medical Officers).

Shoulder tip pain, pain under the ribs, chest pain, breathlessness, a hot swollen shoulder or a new weak arm are never pain-rule questions: see the warning signs. No study has tested a pain rule for shoulder pain in pregnancy.

Sources 50, 67, 59, 58

The exercise plan: 4 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Calm it: gentle movement, little and often

Any trimester, daily, about the first 1 to 2 weeks. Move the shoulder gently through the day, as NHS inform advises, set up your bed (the written steps below) and keep walking. With a diagnosed frozen shoulder, a tear or a slipping shoulder, that guide's plan comes first; with any warning sign, get checked first. No trial has tested this plan as a whole.

Pendulum exercise (Codman's pendulum) demonstrated on the 3D figure

3D demoPendulum exercise (Codman's pendulum)Beginner · A bench or box

Leaning on a table: swings forward and back, side to side and small circles, 2 to 3 of each at a time, every hour or so, building to sets of 8 · NHS inform's arm swings and circles, with its pacing, not the move page's minute of circles. Stand up slowly if you feel light-headed, as the move page says

Harder: Table slide (seated forward reach)

Shoulder rolls demonstrated on the 3D figure

3D demoShoulder rollsBeginner · No equipment

10 to 15 slow circles each way, once or twice through · The move page's dose, an editorial starting point

Harder: Shoulder CARs (controlled articular rotations)

Table slide (seated forward reach) demonstrated on the 3D figure

3D demoTable slide (seated forward reach)Beginner · A bench or box

10 slow reps, 1 to 3 times a day, pain-free while it's very irritable · The move page's dose, an editorial starting point. It replaces NHS inform's shoulder flex on your back in later pregnancy

Easier: Pendulum exercise (Codman's pendulum) · Harder: Overhead lat stretch at a bench (elbows on the bench)

Thoracic rotation demonstrated on the 3D figure

3D demoThoracic rotationBeginner · No equipment

6 rotations each side, sitting, moving with the breath · The move page's dose

Easier: Side-lying open book · Harder: World's greatest stretch

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

About 10 minutes a day if you're new to exercise, building towards 150 minutes a week, arms swinging naturally · The NHS's starting point and its 150 minutes

Harder: Treadmill jogging

Move on when: You can find a position that lets you sleep most of the night, daytime pain is mostly 5 out of 10 or less, and the shoulder is back to its usual level by the next morning (as our shoulder pain at night guide checks; editorial).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Load the rotator cuff and shoulder blades, until the birth

Most days, within the pain rule, sitting, standing or lying on your good side. Strength for the rotator cuff and shoulder blades, the kind of exercise that worked in the trials, built up from small numbers.

Standing band external rotation demonstrated on the 3D figure

3D demoStanding band external rotationBeginner · A band + An anchor point

Light band, elbow at your side: 2 to 3 sets of 5 to 8, building to 3 sets of 15, once a day · The end point is the Holmgren trial's 3 sets of 15; resisted turning out was in the GRASP home programme. Once a day in pregnancy is editorial

Easier: Stick-assisted external rotation (lying) · Harder: Side-lying external rotation

Side-lying external rotation demonstrated on the 3D figure

3D demoSide-lying external rotationBeginner · A dumbbell

Lying on your good side with a cushion under your neck and a pillow under your bump, a light weight such as a tin of beans: 2 to 3 reps at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's side rotation with a weight, with its pacing

Easier: Standing band external rotation · Harder: Cuban rotation

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, sitting or standing tall, stopping 2 to 3 reps short of failure · The move page's dose, an editorial starting point

Harder: Supported single-arm dumbbell row

Scaption raise demonstrated on the 3D figure

3D demoScaption raiseBeginner · A dumbbell

2 sets of 8, thumbs up, to shoulder height, lowering over 3 s, building to 3 sets of 10 to 15 · Editorial, as in our shoulder pain at night guide. Stop below any painful arc

Easier: Band lateral raise · Harder: Smith machine upright row

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

2 sets of 10, small range · Editorial, as in our shoulder pain guide. Move back to a steeper angle if your wrists complain, as the move page says

Harder: Push-up

Move on when: Carry on until the birth within the pain rule. Drop back to the first stage during a flare, and stop for any warning sign.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

After the birth: the first weeks

From the first days, as you feel able: pelvic floor and deep tummy muscles first, gentle shoulder movement between feeds, and walking, as POGP and the NHS advise. After a caesarean, a tear or a complicated birth, go at your own pace and follow your team's advice.

Pelvic floor exercise (Kegel) demonstrated on the 3D figure

3D demoPelvic floor exercise (Kegel)Beginner · No equipment

10 long squeezes held for up to 10 s, with 10 s rest, then 10 short squeezes, at least 3 times a day · POGP's dose after the birth; the move page starts at 8 of each. With a catheter, start once it's out, as the move page says

Side-lying tummy draw-in demonstrated on the 3D figure

3D demoSide-lying tummy draw-inBeginner · No equipment

Hold for up to 10 s, up to 10 times · The move page's dose, which is the NHS's after the birth

Harder: Bird dog, one limb at a time

3D demoPendulum exercise (Codman's pendulum)Beginner · A bench or box

As in the first stage, between feeds · NHS inform's pacing

Harder: Table slide (seated forward reach)

3D demoBand rowBeginner · A band + An anchor point

2 sets of 10 with a light band, sitting tall · Editorial: shoulder-blade work for feeding posture; the move page's full dose comes later

Harder: Supported single-arm dumbbell row

3D demoTreadmill walkingBeginner · Cardio machine

A walk every day, gradually increasing the time and pace over the first 6 weeks, with the pram handles at a height that stops you reaching · POGP's advice; a buggy walk counts

Harder: Treadmill jogging

Move on when: Daily life with your baby is comfortable, and nothing brings on heaviness, leaking or more bleeding: often from about 6 weeks after a straightforward birth, later after a caesarean (our suggestion). The NHS says avoid sit-ups, planks and heavy lifting to start with.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 4

Strength for feeding, lifting and carrying, then everything

From about 6 weeks, 2 or 3 sessions a week, then twice a week for the long term: heavier and overhead strength, one change at a time. Sleeping on the sore side, feeding, carrying and your usual sport come back by the written steps below.

Band internal rotation demonstrated on the 3D figure

3D demoBand internal rotationBeginner · A band + An anchor point

2 to 3 sets of 15 · Editorial, as in our shoulder pain guide

Harder: Side-lying external rotation

3D demoFace pullIntermediate · A band

3 sets of 12 to 15 · Editorial, as in our shoulder pain guide. Check the band attachment first, as the move page says

Easier: Prone Y-T-W raises · Harder: Tuck back lever

Chest-supported dumbbell row demonstrated on the 3D figure

3D demoChest-supported dumbbell rowBeginner · A dumbbell + A bench or box

3 sets of 8 to 12 · Editorial, as in our shoulder pain guide. If the pad presses on tender breasts, raise the incline or add a folded towel, as the move page suggests for the ribs

Harder: Supported single-arm dumbbell row

Shoulder press with a band demonstrated on the 3D figure

3D demoShoulder press with a bandBeginner · A band

3 sets of 8 to 12, once reaching overhead is comfortable · Editorial, as in our shoulder pain guide

Harder: Push press

Scapular push-up (push-up plus) demonstrated on the 3D figure

3D demoScapular push-up (push-up plus)Beginner · No equipment

2 to 3 sets of 10 on a wall or bench · Editorial, as in our shoulder pain guide; a full plank waits, as the NHS advises against planks to start with after the birth

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

Farmer's carry demonstrated on the 3D figure

3D demoFarmer's carryIntermediate · A dumbbell + A kettlebell

2 to 3 carries of 20 to 30 m, light to start · Editorial: practice for a car seat and shopping. After a caesarean, nothing heavier than your baby for about 6 weeks, as the move page says

Harder: Suitcase carry

Move on when: Our suggestion: feeding, carrying, reaching and a full night's sleep have been comfortable for 2 weeks. After the 6 to 8 week check, build from moderate to vigorous activity over at least 3 months, as the UK Chief Medical Officers advise, and keep two strength sessions a week. If the shoulder wakes you more after a busy day, drop back a stage for a few days.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Sleeping with a sore shoulder in pregnancy (written steps)

Our 3D figure can't show these. Each step names its source or is our suggestion.

1. From 28 weeks, go to sleep on your side, either side: the right is as safe as the left, so lie on the side that doesn't hurt (the NHS and a pooled analysis). Support your bump with pillows and put one between your knees (the NHS).
2. Hug a folded pillow in front of you to rest the sore arm on, and put another behind your back so you don't roll onto the sore side (as our shoulder pain at night guide advises; our suggestion here). Put your arm in a supported position when resting (NHS inform).
3. For resting, being propped up on pillows is fine, but settle to sleep on your side after 28 weeks (the NHS).
4. If you wake on your back, turn onto your side and don't worry (the NHS).
5. Once nights have been settled for 2 weeks, try a few minutes on the sore side, rolled slightly forward with the arm on a pillow in front of you, and add a few minutes every few nights (our suggestion, as our shoulder pain at night guide does).

Sources 53, 54, 55, 8

By day: movement, feeding and carrying (written steps)

These come from NHS inform, the NHS and POGP; where a step is our suggestion, it says so.

1. In the first day or two, move the shoulder gently for 10 to 20 seconds every hour while you're awake, then use it more (NHS inform). Don't stop using it completely, and don't make up your own strenuous exercises or use heavy gym equipment (the NHS).
2. Sit with a cushion behind your lower back and rest your arm on a cushion in your lap (the NHS).
3. Before a feed, get comfortable with pillows under your baby and your arms, your shoulders and arms relaxed and your back supported (the NHS). Change holds through the day: the cross-cradle hold went with more shoulder pain in one survey.
4. In pregnancy, avoid lifting heavy objects, bend your knees and keep your back straight, and split shopping between 2 bags (the NHS). Keep loads close and don't hold your breath (POGP).
5. After the birth, carry your baby in a well-fitting sling (the NHS); carriers load your body less than carrying in your arms. Swap hips with a toddler, or use the buggy (our suggestion).
6. Wear a supportive bra through pregnancy and after the birth (POGP).

Sources 8, 47, 65, 66, 68, 3, 13, 4

Heat, ice and painkillers

A pack of frozen peas or a hot water bottle wrapped in a tea towel, for up to 20 minutes, 2 to 3 times a day, can ease the pain; never put heat or ice straight on the skin, and don't use them if you have problems with circulation or feeling. Keep them off your bump (our suggestion). In pregnancy, paracetamol is the painkiller to use, and avoid ibuprofen, including gels, unless a doctor or pharmacist advises it.

Sources 47, 8, 61, 62

Positions to swap, and why

Habit or position	Why it matters	Instead
Lying on the sore shoulder while it's irritable	Lying on the affected side is the usual trigger with rotator cuff pain and frozen shoulder, and either side is safe to sleep on in pregnancy.	The other side, with a pillow hugged in front for the sore arm and one behind your back.
Going to sleep flat on your back after 28 weeks, with pillows under the sore arm	The NHS says going to sleep on your back after 28 weeks is linked with stillbirth.	Propped up for resting, but settle to sleep on your side.
Keeping the arm still, or in a sling, to rest it	The NHS says don't completely stop using your shoulder.	Gentle movement for 10 to 20 seconds every hour, such as pendulum swings.Try: Pendulum exercise (Codman's pendulum)
Face-down Y-T-W raises once your bump makes lying on your front uncomfortable	Lying on the bump becomes uncomfortable, and the move page says use another move as the bump grows.	Band rows and side-lying turning out.Try: Band row
Heavy overhead lifting or new heavy gym work	The NHS says don't use heavy gym equipment while the shoulder hurts, and don't start a new vigorous activity in pregnancy.	Band work below shoulder height.Try: Standing band external rotation
Feeding hunched over in the same hold every time	The cross-cradle hold went with more shoulder pain in one survey.	Pillows under your baby and your arms, different holds, and side-lying feeds.
Carrying your baby in your arms for long spells, or a toddler on one hip	Carriers load your body less than carrying in arms, and rocking a baby to sleep in your arms went with more disability in one survey.	A fitted sling or carrier; swap hips or use the buggy.
Ibuprofen tablets or gel in pregnancy	The NHS says avoid it unless a doctor or pharmacist advises it.	Paracetamol, and heat or ice wrapped in a tea towel.
Putting shoulder tip pain down to a strain in early pregnancy	It can be a sign of an ectopic pregnancy.	Get medical advice right away from your GP or NHS 111, and call 999 with severe tummy pain, bleeding, dizziness or fainting.
Waiting out bad pain under the right ribs after 20 weeks or after the birth	It can be pre-eclampsia.	Call your maternity unit, or NHS 111 after the birth.
Repeated steroid injections	The benefit is small and short-lived, and the shoulder pathway says no more than two.	Exercise, and one injection only after talking it through with your clinician.

Routines to follow

Pregnancy strength workout (no lying on your back)

A 30-minute strength workout for any trimester with dumbbells and a band: squats, rows, hinges, presses and side-lying hip work, none on your back.

30 minBeginner14 movesA dumbbell, A bench or box

Prenatal yoga workout (no lying on your back)

A 20-minute prenatal yoga workout for any trimester: seated breathing, all-fours and kneeling poses, supported standing poses and rest, none flat on your back.

20 minBeginner15 movesA step, A wall

Pregnancy Pilates workout (no lying on your back)

A 20-minute Pilates workout for any trimester: seated, standing, all-fours and side-lying moves, with no lying on your back or front and no jumping.

20 minBeginner15 movesA wall, A bench or box

Shoulder mobility and stability routine (with a band)

A 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.

25 minBeginner12 movesA wall, A band

Neck and shoulder stretches

Eight gentle neck and shoulder stretches for desk stiffness, done standing or seated in ten minutes.

10 minBeginner8 movesA wall

Postnatal exercises

A gentle 25-minute routine for the first weeks after birth: pelvic floor, breathing, tummy and hip exercises on the floor, sit-to-stands and a walk.

25 minBeginner12 movesA bench or box, Cardio machine

Postnatal strength workout (from about 6 weeks)

A 25-minute strength workout from about 6 weeks after birth: sit-to-stands, deadlift practice, push-ups, rows, bridges and tummy work, with the knack.

25 minBeginner14 movesA bench or box, A kettlebell

More moves for this area

Questions people ask

Is shoulder pain normal in pregnancy?

It's fairly common and usually comes from the neck and shoulder muscles or the rotator cuff: about 6% to 8% of women reported it in each trimester in one Turkish hospital study. It becomes more common after the birth, with feeding and carrying. Shoulder tip pain in early pregnancy, or bad pain under the right ribs later on, needs checking straight away.

Does shoulder pain in early pregnancy mean an ectopic pregnancy?

Usually not, but shoulder tip pain, where the shoulder ends and the arm begins, can be a sign of an ectopic pregnancy bleeding inside, so get medical advice right away from your GP or NHS 111. Call 999 if it comes with sudden severe tummy pain, bleeding, dizziness or fainting. About 1 in 90 pregnancies is ectopic.

What does ectopic shoulder pain feel like, and does it come and go?

The NHS calls it an unusual pain where your shoulder ends and your arm begins. It isn't brought on by moving your arm, and it usually comes with tummy pain low on one side, bleeding or a brown discharge, or discomfort peeing or pooing. Don't wait to see whether it comes and goes: get advice the same day.

Why does my right shoulder hurt in pregnancy?

Usually the muscles, the rotator cuff or sleeping on that side. From 20 weeks or after the birth, bad or persistent pain under the right ribs can be pre-eclampsia and needs your maternity unit. Gallstone pain under the right ribs can also spread to the shoulder blade.

Can trapped wind cause shoulder pain in pregnancy?

The NHS says tummy pain in pregnancy is probably nothing to worry about if it's mild and goes away when you change position, rest, do a poo or pass wind. Shoulder tip pain is different: in early pregnancy it can mean bleeding inside, so get advice. During or after a caesarean, shoulder tip pain is common and usually settles within about 3 days.

How should I sleep with shoulder pain while pregnant?

From 28 weeks, go to sleep on your side, and either side is safe, so lie on the one that doesn't hurt. Hug a pillow to rest the sore arm on, put one behind your back, and support your bump and knees with pillows.

What exercises help shoulder pain in pregnancy?

Gentle arm swings and shoulder rolls first, then band exercises for the rotator cuff and shoulder blades, sitting, standing or lying on your good side. Exercise like this helped rotator cuff pain in trials in other adults. Avoid long spells flat on your back in later pregnancy.

What can I take for shoulder pain when pregnant?

Paracetamol is usually the best painkiller in pregnancy; avoid ibuprofen, including gel, unless a doctor or pharmacist advises it. Heat or ice wrapped in a tea towel for up to 20 minutes helps too.

Can I have a steroid injection for my shoulder while pregnant?

It's a decision for you and your clinician, case by case: one review found no harm reported from a single local injection. For rotator cuff pain the benefit is small and lasts weeks, not months, so exercise comes first.

Why does my shoulder hurt when I breastfeed?

Long feeds in one hold load the shoulder, and the cross-cradle hold went with more shoulder pain in one survey, where about a third of breastfeeding mothers had shoulder pain. Get comfortable first with pillows under your baby and your arms, keep your shoulders relaxed, and change holds through the day.

My hands tingle and my shoulder aches. Is it connected?

Tingling in the thumb and first fingers, worse at night, is usually carpal tunnel syndrome at the wrist, which about a third of pregnant women report, and it can ache up the arm. Pain running from the neck down the arm with pins and needles can come from the neck, even without neck pain.

When does shoulder pain go after the birth?

Most muscle and joint symptoms of pregnancy improve after the birth, and rotator cuff pain usually settles over weeks to months. If it's still bothering you, ask your GP or health visitor, or raise it at your 6 to 8 week check. In many areas you can refer yourself to physiotherapy.

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.