Postpartum/breastfeeding joint and tendon pain

[JP1993]

Postpartum inflammatory joint and tendon pain – has anyone experienced this?

Hi,

I’m hoping to hear from others who may have experienced something similar postpartum, because I’m struggling to understand what’s happening and whether this can settle with time.
I’ve had two very close pregnancies (two under two) im 9 months postpartum and I’m currently breastfeeding (I've read this can make things worse). I am 32, I got pregnant with my second whilst still breastfeeding my first weaned my first baby at 11 months old whilst pregnant with 2nd. My symptoms started during pregnancy, initially as pins and needles and tingling in both hands, and I was diagnosed with carpal tunnel in both wrists.

Over time, things progressed rather than staying just carpal tunnel:

• The pins and needles evolved into ongoing wrist pain (tender to touch)
• Then I developed trigger finger–type symptoms (locking/catching fingers)
• After that, pain started in the balls of my feet, so it clearly wasn’t just carpal tunnel
• Since then, the pain has become symmetrical both knees, both wrist, both feet and inflammatory, involving:
• hands and wrists
• Wrists tender to touch
• fingers (triggering/stiffness)
• knees
• balls of the feet and toes
• occasional shoulder and base of neck pain
• Knuckle joint

I experience morning stiffness (lasting well over an hour). Movement helps a bit, but the pain never fully goes away. I dont have any swelling present nor does it feel hot to touch. I suddenly feel like Ive been run over and sewn back together poorly and now have the body of a 90 year old.

I recently had steroid injections in both wrists for carpal tunnel, which did help the numbness/tightness carpal tunnel symptoms, (this was short lived and now it's back) but did not help:

• trigger finger
• joint pain

Or obviously everything else going on.
That made it clear to me this wasn’t just a nerve issue.
I’ve had blood tests including ESR, CRP, full blood count, B12, thyroid, diabetes, etc — all normal. Vitamin D was borderline low and low folic acid. My GP has referred me to rheumatology to rule out rhuematoid arthritis and I have a referal in for Orthopedics for carpal tunnel and trigger fingers. (Both wait times of months while things seem to worsen every day)

My knees of a morning make it difficult to go down stairs, picking up my baby, changing nappies, opening things and simple tasks cause pain. My hands take forever to seem to work again but the pain never completely goes.

A lot of the pains also seem to be tendon related as well as joint.

I’ve been reading about postpartum or hormone-related inflammatory arthritis, and how breastfeeding, low oestrogen, and relaxin may play a role. I’ve seen posts from women saying their symptoms improved or even resolved after weaning or with time.

I have currently stopped breastfeeding currently one week with no breastfeeding.

I’m wondering:
• Did anyone have symptoms that started as carpal tunnel/nerve pain and then evolved into widespread joint pain?
• Did it turn out not to be RA?
• Did breastfeeding seem to worsen things?
• Did symptoms improve after weaning or once hormones stabilised?
• How long did it take for things to calm down?

sorry for the long post.

Thank you so much to anyone who’s willing to share 🤍

Have your symptoms improved at all now you’ve stopped BFing for over a week?

I didn't have carpal tunnel, but I did have really awful knee pain. I also read that it could be related to breastfeeding and it did just go away with time for me. I'd say around 9/10 months. I hadn't stopped bfing but I guess feeds had started to reduce.

I didnt have the carpal tunnel symptoms but I had everything else that you mention, and it was all related to low Vit D. The GP advised on what level Vit D I should be taking (1000ui 2x per day for two months, then drop down to 1x per day) and then was planning on rechecking my bloods, but even in those two months, I saw a huge improvement. I was still bf throughout - i think it shouldn't be underestimated how much bf can take out of us. Did the GP advise you to up your vit D if it was borderline? Don't rely on a bf multivitamin - id add a dedicated vit D supplement in the mix. At the very least it cant hurt.

It is common for women with inflammatory arthritis to have a flare postpartum. This would be my first thought.

A flare can last months and settle itself. Postpartum things do tend to settle.

Those are the bloods I would want you to have and a rheumatologist referral.

I would suggest taking vitamin D and folic acid if you are not already.

Personally I’d take a regular anti-inflammatory tablet like ibuprofen 400mg or naproxen twice daily after food, for 2 weeks as a trial. You might need a stomach tablet to take this regularly.

Yes carpal tunnel can be a consequence of inflammatory arthritis but also common in and after pregnancy.

I haven’t personally seen significant widespread joint pains with breastfeeding for better or worse. I have met a lot of women with postpartum aches and pains, backache or joint pains etc breastfeeding or not, but you are describing something more.

I’d ring the booking office, check exact waiting time and ask to be put on the short notice/ cancellation list for rheumatology. It would be about £250 for a standalone private rheumatology appointment if you have the money/ if the waiting list is many months.

No change as of yet but Ive seen others say it takes 6 weeks or so to notice a difference

Yes I'm on a vitamin D supplement and 5mg folic acid this has only been about 3 weeks though so not noticed a difference yet.

Ive been taking vitamin d and 5mg folic acid for around 3 weeks now so not sure if thats long enough to notice a difference also been given naproxen and omoperazole from gp and have rung rhuematolgy for potential cancellation list however they advised im already an urgent referral and basically it takes as long as it takes 😩 if this was down to a postpartum arthritis flare would this keep coming back? Or settle completely? Thanks

It can take between 2 - 6 weeks to get symptomatic benefit from vitamin D and folic acid supplements.

You have been very pro-active about this and it does sound like a waiting game now to get a rheumatology review and possible diagnosis.

If this is a non autoimmune inflammatory arthritis, this happens once and resolves. It can last months, I would say most times resolves by 3-4 months but could be more gradual and up to a year at very longest.

If this is a first presentation of an autoimmune inflammatory arthritis (like rheumatoid arthritis), then it will be a relapsing condition, so it tends to happen in flares that last months. If this is the diagnosis you will likely be offered medications at diagnosis that are to settle your symptoms/stop the progress. There is an expansion of treatment options in recent years and most people find something that works well.

A little gentle exercise is not going to do any damage and might help your symptoms a little. So a walk (not a big hike)/ pilates or a swim. x

Ive stopped breastfeeding completely now for a little over three weeks and unfortunately I would say it hasn't made any difference at all so far.