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Surely backache should rank among the types of pain in pregnancy?
Yes. Backache after the midway stage of the pregnancy becomes increasingly common. The not-so-good news is that it tends to worsen as the pregnancy advances and it responds poorly to the common painkillers based on paracetamol and/or codeine. The good news is that there is almost always nothing wrong with the pregnancy and the backache tends to clear up soon after delivery.
The main cause is usually strains to the spine by the increasingly heavy uterus.
Poor posture, physical exertion and wrong sleeping positions could worsen backache. The attending midwife should be able to advise on this. It is however important to remember that pathological conditions such as kidney infection could cause symptoms of backache, although there are almost always other symptoms. If left untreated, kidney infection worsens rapidly.
Symphysis Pubis Dysfunction (SPD)
What about pelvic girdle pain (Symphysis Pubis Dysfunction)?
This is one of the causes of intractable and progressive pain in pregnancy. It usually starts in the second half of pregnancy, rarely before 28 weeks.
It is usually felt around the pubic area and the side joints of the pelvis. Movements and especially rolling from side to side in bed exacerbate the pain. Climbing stairs can be torture.
The cause is partial separation of the joints under the influence of pregnancy hormones, especially progesterone.
The truth is, painkillers hardly touch this pain but a special brace worn around the pelvis to stabilize the joints may help control the exacerbation caused by movements. It is not the most comfortable of devices.
Physiotherapy can be tried in SPD but its role is limited and benefit modest at best.
The pain, in most cases, subsides soon after delivery and clears up completely within a few weeks of delivery. Persistent pain is rather unusual but up to 1 in 14 women will report lingering pain and limited mobility up to 6 months after delivery.
Recurrence of SPD in a subsequent pregnancy is common. When this happens, it tends to appear earlier in the pregnancy.
The condition goes by the terms ‘symphisis pubis dysfunction’ or diastasis symphysis pubis also abbreviated as SPD or DSP respectively.
So, what type of painkillers are recommended for use in pregnancy?
Paracetamol (Acetaminophen) usually suffices for most types of pain in pregnancy and is perfectly safe for the baby. If a stronger painkiller is required, then most obstetricians will recommend preparations based on a combination of paracetamol and codeine (or dihydrocodeine). There are several such preparations. The most common side-effect of these is constipation.
Last update: February 24, 2013