Why I asked the doctor for prescription-only medication for pain
Jane has four children but experienced PGP only in her last pregnancy. She says she had the advantage of having a friend with PGP so she knew about it before she started to show the symptoms herself.
I was very aware of how often pain relief came up in conversation about pregnancy. In each of my pregnancies I had been with friends who were expecting at about the same time and the conversation about lower back pain often came up. The chats occasionally included whether or not it is safe to take any drugs to reduce pain when you are pregnant – whether for back pain related to PGP, headaches or some long term issue of coping with an injury.
I didn’t take much part in these conversations during my first three pregnancies. I have always been quite a fit and healthy person and haven’t been prone to headaches or difficult period pains before I started my family so I just didn’t need to think about the subject. When my friend Mandy found she had PGP towards the end of her pregnancy, around the time of my third pregnancy, I knew that she experienced severe pain but I didn’t have any idea about whether she took pills to reduce it. I think I was just aware that we modified what we were doing when we met up so she could cope and manage the PGP. Generally, we just took things slowly and didn’t walk too far.
When I was pregnant with Jo, my fourth child, the PGP symptoms started in the third month. Unlike my friend Mandy my mobility wasn’t really affected but I did have a very sharp and uncomfortable pain if I carried anything or bent down. I also found it very painful and uncomfortable trying to turn over in bed or get out of the bed or bath.
I think the disturbed nights were the hardest thing for me. I felt absolutely wrecked the next day and couldn’t function properly in my relatively demanding job. My husband bought me a great pillow which was oversized and helped me to get comfortable at night in bed. Also, my friend Mandy told me about a special sheet to help me move more easily in bed. These things helped but it didn’t take me long to realise that not sleeping at night was making me very tired during the day and when I was particularly knackered, I seemed to feel even more pain. Quite early on, I went to see the GP and asked about what I could take to help me control the pain at night so that I could sleep. I found this very helpful and I would strongly advise anyone who has PGP and wants to manage the pain to go and discuss the options with her doctor.
No-one wants to put their baby at risk but my doctor and pharmacist reassured me that there are strict guidelines about the drugs that are recommended in pregnancy. As a result, I felt that as long as I kept very much to the guidelines about what and how many pills to take, I would benefit and my baby wouldn’t experience any detrimental effects. I did ask about whether I might get addicted to the painkillers if I took them for the duration of the pregnancy because I didn’t want to rely on them when I no longer had PGP. I was told that dependency was unlikely but I did make sure that I didn’t use them every single day because I was worried that I just might get hooked!
The GP suggested that I tried over-the-counter pills first to see if any of them helped. I tried paracetamol but although it helped, it didn’t numb the pain enough for me to sleep. I also tried ibuprofen but then found out from the GP that actually it isn’t usually used in pregnancy and is not recommended when breastfeeding. Apparently, the occasional dose doesn’t cause a problem but to be effective in PGP, it needs to be taken regularly for at least two weeks.
I think the GP encouraged me to try various drugs over time but from the lower end of the scale so we worked up to more powerful ones, only if the others really didn’t work. I think when I first spoke to the doctor, I was worried about side effects, such as constipation or feeling sick. I really didn’t think that anything would be prescribed that might threaten the baby’s health because I had been reassured that we could discuss the best options.
My doctor thought that if the less powerful drugs didn’t work for me, we could always try combinations to see if that was more effective for me. However, I think I had something like Naproxen prescribed and that really worked for me. At first I thought it was upsetting my stomach but actually I found that it was something else I was eating that was doing that! The other thing I would add is that my pills worked best if I took them with food an hour or so before I started to get ready for bed. Otherwise, I think they can irritate the stomach.
When I was referred to see a physio to treat the PGP, it was a big relief but the first few visits were very painful because I had a lot of inflammation around my pelvis and so it felt really sore when I first had manual therapy. It was the physio who suggested that I might want to take some paracetamol with codeine during the visits to her and also to relieve the pain after a treatment session so that everything could ‘settle down’ again. I think I discussed this with the GP because I didn’t want to cause any difficulties by then having the more powerful prescription product at night. I can’t remember the details now but we did find a way that worked for me and the treatment sessions with the physio were certainly much less painful.
I think it is important to stress that I wasn’t taking pills all the time. There were days when I didn’t need to take anything and, frankly, I didn’t really need anything during the day. It was just at night because if pain stopped me getting to sleep then the aches and pains of PGP seemed so much worse the next day. I also think that I stopped taking anything in the last month of pregnancy. This was partly because the GP suggested it wasn’t a good idea and partly because I found that, once I had finished work, I wasn’t experiencing as much pain and could rest during the day which helped.
I would really encourage women to go and see their GP to discuss the options and to be reassured about which medicines are safe in pregnancy and breast-feeding. I think I also read up on some of the drugs for myself by consulting the British National Formulary (BNF) as that gave a lot of information about them. I think I found the BNF as a book but it might be possible to read it online now.
Thanks, Jane, for sharing your viewpoint and experience. We would stress that taking any kind of medication during pregnancy or breastfeeding is something that should be a personal decision based on discussions with your GP. What works for one person may not be the answer for another person so it may not necessarily follow that an over-the-counter preparation that worked for a friend with PGP will automatically work for you. Of course, it is important to look for manual therapy from a qualified healthcare professional (such as a physiotherapist, osteopath or chiropractor) as this treatment should be able to address the underlying causes of PGP where pain relief will just relieve the symptoms. You may have to discuss and try several options provided by your doctor before you find one that suits you and minimises the pain.