Postpartum Joint Pain: Causes And Tips For Relief

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Arthritis is a condition characterized by stiffening and swelling of joints resulting in decreased range of motion. Although this is a common geriatric problem, arthritis after pregnancy may occur in a few women. This condition could be due to physical changes after pregnancy and childbirth. It may be present for a few weeks or a few months after pregnancy. Postpartum arthritis may cause a lot of discomfort to the mother and may also impact her mental health and overall well-being. Hence knowing the right treatment and caring measures could be helpful. Continue reading the post for more information.

Is Arthritis Common After Pregnancy?

Arthritis is common in people of all ages. It may aggravate after pregnancy and a few women are likely to experience arthritis flare-ups or joint inflammation, after childbirth (1). They may have postpartum joint disorders that may cause pain in their wrists, hands, ankles, and feet.

According to gynecologist & obstetrician Dr. Nisarg Patel, “Pregnancy arthritis usually goes away after delivery, but some women may continue to have symptoms for a few months or longer. If your joint pain and stiffness persist beyond six weeks of delivery or interfere with your daily activities, you should see your doctor for a proper diagnosis and treatment.”

Quick fact

Changes in the immune system is responsible for remission of arthritis in pregnancy and flare ups in the postpartum period (11).

Causes Of Arthritis After Delivery

New mothers may have postnatal joint discomfort or arthritis for the following reasons.

• During pregnancy, most autoimmune diseasesⁱRelated to conditions where the immune system attacks the body’s healthy cells due to a malfunction , such as rheumatoid arthritisⁱA condition where the immune system attacks the tissues lining the joints on either side of the body or psoriatic arthritisⁱType of arthritis seen in people with psoriasis, which is also an autoimmune condition causing itchy, red patches on the skin , go into remission because of the vigorous antibody and cell-mediated immune responses. The symptoms may again flare up after pregnancy (2).
  Sharing her experience, Stephanie Kay, a mother of four and homeschool teacher, talks about how she always wanted to be a mother but feared how her rheumatoid arthritis would affect the pregnancy. After being on the medication Enbrel and therapy, she decided to have a baby and describes how her rheumatoid arthritis went into remission, allowing her to have a comfortable pregnancy. She says, “I jokingly tell my husband I would always feel great if I could stay 2nd trimester pregnant all the time (puking is over but I’m not as big as a barn). That may sound odd until you learn that for most women RA goes into remission (inactive) during pregnancy! The funny thing is that after the baby’s born RA usually rears it’s ugly head again.  I’m no exception.  6 weeks after delivery I start feeling the old aches and pains and inflammation again (i).”
• The immune system usually becomes stronger after pregnancy. The overactive immune system may lead to pre-existing allergies or autoimmune diseases such as rheumatoid arthritis (RA), lupusⁱA condition in which the immune system attacks its tissues, causing inflammation , or psoriatic arthritis (3).

• Age, genetics, obesity, physical inactivity, smoking, infections, occupation, and diet deficiencies may also lead to arthritis flare-ups during the postpartum period (4).
• Cartilage is a firm tissue that protects your bones and joints and an eventual cartilage damage can lead to osteoarthritisⁱA condition in which tissues in the join gradually break down and degrade over time where bones rub against bones.
• Hematogenous seedingⁱAn infection that spreads to other parts of the body through blood. of bacteria contacted during birth or from nipple trauma during breastfeeding may result in postpartum septic arthritis.
• The physiological effects of pregnancy, such as weight gain, water retention, and bearing an unbalanced load on loose joints, may cause wear and tear in the knees, triggering inherent genetic traits for arthritis postpartum (18).

Although postpartum musculoskeletal pain often results from injuries to bones or ligaments, it can also be associated with osteoarthritis and rheumatoid arthritis.

What Should You Do If You Have Postpartum Joint Pain or Arthritis?

Some measures that might help in managing and treating postpartum joint stiffness or arthritis are:

1. See a doctor: Seek medical help if you already have arthritis. The doctor may give treatment to minimize pain, reduce joint damage, and improve the quality of life. You could only achieve them through regular follow-ups and by following the recommended treatment.

Quick tip

Discuss with your doctor and plan your medications based on breastfeeding schedule to minimize its effects on babies (12).

2. Have a balanced diet: Plan a healthy post pregnancy diet with your nutritionist. Include low-calorie, low-fat foods, and plan your meals and snacks in a way that you are having a balanced diet. Your doctor may advise you to include omega-3-rich foods and supplements such as fish oil to help with inflammation and improve the health of joints and muscles (20).
3. Manage your weight: Losing the excess weight and maintaining a healthy weight could be helpful if you have arthritis. It can lower the stress on joints, especially the hips and knees. Being overweight may also increase the risk of having arthritis. According to the US CDC’s Prevalence of Arthritis and Arthritis-Attributable Activity Limitation Report 2016–2018, about 28.8% of obese adults experience arthritis (19).
4. Stay active: Being physically active by engaging in exercises could relieve pain and improve your mood. You may do a combination of different exercises, from aerobic workouts to strength training. Range of motion exercises, stretching, swimming, cycling, and walking can help maintain the flexibility and functionality of joints while increasing endurance. Strength training exercises, yoga, and pilates may help build muscles, stabilize joint supporting tendons, and improve overall physical strength (14). Exercising also decreases your chances of developing chronic conditions such as diabetes, hypertension, and heart disease. Speak to your doctor to know the safest postnatal exercises you can do to manage arthritis.

5. Improve your self-management skills: You may join a self-management education program to learn skills to manage arthritis. It could help you gain control over your health, manage pain and its symptoms, reduce stress levels, improve mood, and communicate better with your doctor (5).
6. Wear correct size comfortable footwear: Avoid high heels. Ensure the sole is soft and gives adequate cushioning.
7. Get adequate rest: It is important to ensure that you rest while your joints feel stiff and painful to assist your body in remedying muscle fatigue and reducing inflammation. The period of rest will allow you to regain some lost energy and help you resume your exercise routine(14)(20).
8. Avoid tobacco and alcohol: Studies indicate smoking as a risk factor for the development and worsening of rheumatoid arthritis(21). Similarly, consumption of alcohol may cause some interactions with medications prescribed for the management of arthritis, worsening the symptoms. Thus, lifestyle changes such as quitting smoking and reducing or avoiding the intake of alcohol are necessary to manage arthritis(14).
9. Focus on your mental health: Pregnancy and postpartum are an intense period where the mother may constantly battle symptoms of stress and depression. Studies exploring the link between poor mental health conditions and arthritis indicate depression as a likely causal trigger for rheumatoid arthritis (22). Stress has also been linked with worsening the symptoms of arthritis. Thus, you must opt for suitable ways to relax postpartum including having regular massages or acupuncture, meditation, deep breathing, and visualization to cope with the symptoms (20).
   However, despite making these lifestyle changes to manage arthritis, if you continue to experience uncontrollable symptoms due to recurring flare-ups after pregnancy, speak with your doctor.

Can You Get Rheumatoid Arthritis After Pregnancy?

There is a risk of developing autoimmune diseases such as rheumatoid arthritis after pregnancy. Although there is no substantial evidence to support this claim, there is a belief that complex hormonal changes and immune-related shifts occur during and after pregnancy. This could be a plausible reason for an increase in the rate of postpartum rheumatism (6). However, pregnancy alone need not be a reason for getting RA, as other factors such as genetics play a more important role.

Does Breastfeeding Make Rheumatoid Arthritis Worse?

Breastfeeding may not worsen rheumatoid arthritis. But some mothers with RA may have chronic pain while holding the baby for breastfeeding. It can also affect arthritis treatment since some medications aren’t safe during breastfeeding. Therefore, it is important to consult your healthcare provider to find pain relief options that are safe during breastfeeding.

Does Postpartum Arthritis Go Away?

Unfortunately, there is no cure for arthritis. However, early treatment and a healthy lifestyle could help you manage the condition and improve your quality of life (7).

Infographic: What You Should Know About Postpartum Arthritis?

Arthritis can be suppressed during pregnancy due to biochemical changes in the body. However, postpartum comes with an exacerbation of the condition. Timely management could help to deal with flares better. Go through the infographic to learn about postpartum arthritis.

Illustration: Momjunction Design Team

Illustration: Postpartum Joint Pain (Arthritis) Causes And Tips To Manage

Image: Dall·E/MomJunction Design Team

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Reviewer Expert Author Editor Fact Checker

Dr. Sangeeta AgrawalFRCOG, MD, DNB, DGO

Dr. Sangeeta Agrawal is an obstetrician and gynecologist with around 29 years of experience in the field. She worked in Royal London, St. Bartholomew’s, North Middlesex, and Barnet General hospitals in London and currently runs her clinic in Mumbai.

Read full bio of Dr. Sangeeta Agrawal

• 
  Dr. Nisarg PatelMBBS, MS Dr. Nisarg Patel is a gynecologist, obstetrician, and laparoscopic surgeon from Ahmedabad, India, with over 13 years of experience in the field. He did his post graduation in Obstetrics and Gynecology from Pravara Institute of Medical Sciences, Ahmednagar, and holds a fellowship of Reproductive Medicine.
  
  Dr. Nisarg Patel is a gynecologist, obstetrician, and laparoscopic surgeon from Ahmedabad, India, with over 13 years of experience in the field. He did his post graduation in Obstetrics and Gynecology from Pravara Institute of Medical Sciences, Ahmednagar, and holds a fellowship of Reproductive Medicine.

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

Read full bio of Rebecca Malachi

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

Read full bio of Swati Patwal

Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

Read full bio of Dr. Joyani Das