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Weakness and pain around joints, ligaments, and tendons in the postpartum period is not unusual — whether you look around SteadyHealth or other online places where women who have recently given birth converge, you'll find a lot of puzzled new mothers who desperately want answers. These symptoms of physical weakness are often accompanied by fatigue, and some women also report hair loss.

Some have dubbed the phenomenon "postpartum pain syndrome". Others suspect they have rheumatoid arthritis, only to walk away from an appointment with a rheumatologist without any answers. 

What can be going on, here? A few things, actually. 

Postpartum recovery, pain, and fatigue

Postpartum fatigue is incredibly common, and can last for up to six months. When you experience feelings of physical weakness and pain in the immediate postpartum period, it is fairly safe to assume that your symptoms are physiological and normal. You are recovering from pregnancy and childbirth. Interestingly, women who have just had their first baby tend to be hardest-hit, while those who had subsequent children are less likely to be severely fatigued. 

On a related note, hair loss is not uncommon during the postpartum period. This is is because you do not lose as much hair while you are pregnant, but your body makes up for that later as your hormones return to normal. 

Postpartum depression

In addition to the usual symptoms of depression — such as a depressed mood (feeling down, sad, tearful), feeling hopeless, guilty, unworthy, and losing interest in everyday activities — women with postpartum depression may also question whether they are suitable mothers and feel a disconnection from their babies. Postpartum depression is more serious than the "baby blues" which many women experience, and gravely impacts daily life. It can lead to feelings about death, suicide, and even harming your baby, but certainly not always. 

Depression is also well-known to have the potential to induce vague physical complaints. It is possible that postpartum depression is the cause of the joint, tendon, and/or ligament pain and weakness in some of the women who describe this problem.

Fibromyalgia

Fibromyalgia is a debilitating central sensitivity syndrome characterized by widespread pain and soreness in the muscles, joints, and tendons. Normal touch feels painful, and especially sore tender spots can be found in different parts of the body. Patients can feel extremely fatigued and weak. This condition still remains fairly poorly understood, but research points to the idea that symptoms are often triggered by physical injury or emotional stress or trauma. 

There is evidence that fibromyalgia symptoms tend to grow more intense during pregnancy, but no research pointing in the direction that pregnancy or childbirth can directly induce fibromyalgia. However, it is possible that some of the women describing weak and painful muscles, joints, and tendons, whose symptoms started around the postpartum period but persisted long after, may have fibromyalgia. 

Rheumatoid arthritis

From what I've seen, many women describing this set of symptoms worry that they could have rheumatoid arthritis. Some, indeed, end up with this diagnosis, while rheumatoid arthritis is ruled out in others. It is interesting to note that rheumatoid arthritis symptoms often clear up or reduce during pregnancy, only to come back with a vengeance — that is to say, much more intensely — after the patient gives birth. If you had undiagnosed rheumatoid arthritis prior to your pregnancy, it is possible that you will suddenly feel much worse in the postpartum period. 

Any woman who feels experiences severe weakness, pain, or both in her muscles, tendons, or joints, or ligaments after recently having a baby would be wise to discuss her concerns with her doctor. It is normal to feel all kinds of off in the first days, weeks, and even months after giving birth, but if your pain and weakness does not subside and doesn't have an obvious explanation like pain around a c-section site, it warrants medical attention. 

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