Musculoskeletal Pain in Pregnancy

Abstract

The musculoskeletal system is a highly integrated network of bones, muscles, tendons, ligaments, and connective tissues that give shape to the human body and allow it to move. It supports other systems and provides the structure and stability to walk, lift, grasp, work, exercise, and perform activities of daily living. It is also highly susceptible to alterations in its internal and external environments, many of which can place stress on the individual components or on the system as a whole. Pregnancy causes hormonal and other physiologic changes that lead to weight gain, joint laxity, and varied biomechanics, all stressors that can induce musculoskeletal pain and provoke injury. Widening of pelvic joints, increased lumbar lordosis, gait deviations, compression of peripheral anatomy, abnormal pressure distribution, and a host of other factors make pregnant women susceptible to pain and dysfunction, commonly of the foot, knee, hip and pelvis, low back, and wrists. Most conditions are self-limited and respond to conservative treatment such as activity modification, postural support, soft tissue mobilization, and formal strength training. Injections of anesthetic and corticosteroid around tendons and into joints may serve a role in short-term pain management and pose no known risk to the developing fetus. X-rays and advanced imaging are usually unnecessary, though when indicated to rule out fractures, bone tumors, or other serious pathologies, they are also safe for the fetus and prospective mother.