Chronic Pain Management in Pregnancy

Alternative Therapies for Pregnant Women With Chronic Pain

Chronic pain can be quite difficult to manage during pregnancy due to the potential risk of pain medications to the fetus. All pain medications are classified by the FDA into categories describing the risk to the fetus, and if they should be used by pregnant women. Oftentimes if medication is required to treat the chronic pain, the benefits to the pregnant woman, out-weighs the risk to the fetus. Several alternative therapies are recommended and reviewed before medication with potential risk to the fetus will be prescribed.

Alternative therapies that have been shown to help alleviate chronic pain during pregnancy include acupuncture, water therapy, massage and physical therapies. Some other non-medication treatments that can help to reduce chronic pain symptoms include hot and cold therapy, meditation, and yoga. Acupuncture is well tolerated by pregnant chronic pain patients and is especially helpful with chronic back pain. It does not appear to present any harm to the fetus. It has also been found to be slightly more effective in relieving chronic pain than physical or massage therapy, although both of these therapies can be of great assistance in pain relief as well.

Water therapy and water aerobics can also be quite beneficial for a pregnant woman dealing with chronic pain. It is a great way to strengthen muscles and bones without putting added pressure on weight-bearing joints such as the hips, ankles and knees. Resistance training in the water is an ideal way to help reduce the added pressures and pains carrying the added weight of a baby can cause.

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Yoga and meditation can also be helpful therapies when dealing with chronic pain throughout pregnancy. Meditation will help to relax the body, which can relieve stress and irritation to the affected area of the body, and this can help to reduce pain levels. Yoga is centered around relaxation and stretching. Stretching the area of the body affected by chronic pain can also help to reduce the pain levels and inflammation that are being experienced. It is important to participate in yoga classes that are geared towards pregnant women, as some poses may cause more irritation and pain to the pregnant woman.

If alternative therapies such as acupuncture are not enough, pregnant women suffering from chronic pain will often have to look at taking medication as well. The most common pain medication that is taken by pregnant women is acetaminophen (Tylenol). It is believed to be safe for use throughout all stages of pregnancy and has not presented any cases of abnormalities or adverse pregnancy outcomes. Ibuprofen (Advil) has several mixed statistics on whether it is safe for use during pregnancy. It has also been shown to be safe for short-term use through the first and second trimesters of pregnancy; however, it is not recommended at all through the third trimester due to the increased risk of heart and lung damage to the fetus. Aspirin is a medication that should be avoided, as it can increase the risk of bleeding.

Some medications should be avoided during pregnancy altogether. This would include the majority of medications in the opioids family, such as morphine, hydrocodone, oxycodone, etc. These medications can be dangerous because they are addictive, and the addiction to these medications can be passed on to the fetus at birth. If the mother is taking these medications and decides to quit, the withdrawal symptoms can also cause miscarriage earlier in pregnancy and stillbirth in the later stages of pregnancy.

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