9 Types of Pain Relief When You're Pregnant: What to Know

Medically Reviewed By William C. Lloyd III, MD, FACS

Written By Lorna Collier on June 26, 2020

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  What to Know About Safe Pain Relief When Pregnant

  It's pretty hard to get through pregnancy without aches and pains, whether it's low back pain, joint pain, headaches or other discomfort. Most pregnant women (65 to 70%) take acetaminophen at some point; another quarter take ibuprofen. But what do experts say about taking pain medication while pregnant? Which pain relievers are safe—and which should be avoided? Here's a look at some common pain medications, as well as alternative remedies.
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  Acetaminophen (Tylenol)

  Most health providers recommend acetaminophen over other medications to relieve pain during pregnancy. However, it carries risks too. A study of 64,000 children found those whose mothers used acetaminophen while pregnant had a 13 to 37% higher risk of developing attention-deficit/hyperactivity disorder (ADHD); the risk grew the later in pregnancy the drug was taken. Some studies link frequent use to children developing asthma or mild developmental delays (others disagree). It's best to take the lowest effective dose and only as necessary. Make sure you don't inadvertently double-dose by also taking it in cold or other combination medicines.
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  Ibuprofen and other nonsteroidal anti-inflammatories (NSAIDs)

  You should avoid ibuprofen (Advil, Motrin) and naproxen (Aleve) during your third trimester, because they can cause a serious heart vessel problem in your baby. If you must take ibuprofen after 24 weeks, your doctor may need to monitor your fetus's heart and amniotic volume by ultrasound. You also should be taking the lowest dose possible to manage your pain. Most experts say NSAIDs are safe to take early in pregnancy, though some studies have found links to birth defects or miscarriage (other studies have not shown this).
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  Aspirin

  Regular-strength aspirin (325 mg) is not recommended during pregnancy. If you take it early in your pregnancy, it may raise your risk of miscarriage or birth defects. In the third trimester, it's linked to heart problems for the baby. Low-dose aspirin (60-100 mg daily) may be taken; but, because the dose is so much less than regular aspirin, it is usually less effective against pain. However, doctors sometimes recommend this low dose to prevent miscarriage, clotting disorders, and preeclampsia.
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  Oxycodone and other opioid pain relievers

  Oxycodone (such as Oxycontin and Percocet), hydrocodone (Vicodon, Norco) and codeine are opioids that healthcare providers prescribe if you have moderate-to-severe pain. Women who take greater-than-prescribed amounts of these drugs and for longer than recommended periods of time risk stillbirth, premature delivery, C-section, poor fetal growth, having babies born addicted to the drug (neonatal abstinence syndrome), and having the child develop learning and behavior problems later on. Some studies suggest opioids may slightly raise the risk of babies being born with heart defects or cleft lip and palate.
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  Migraine medications

  For many women, migraines disappear in pregnancy. Others are not so lucky. To quell migraine pain during pregnancy, doctors recommend acetaminophen, low-dose aspirin (75 mg), relaxation techniques, and avoiding known triggers. If necessary, some prescriptions are OK: propranolol, amitriptyline, sumatriptan (if taken less than twice a week), and rizatriptan. Avoid ergotamine and aspirin above 75 mg. Topiramate or sodium valproate may increase the risk of birth defects, so discuss taking these with your healthcare provider.
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  Herbal supplements

  If you have arthritis, you may find it gets worse during your pregnancy. Water weight gain during pregnancy can also cause your feet, hips, knees, ankles and fingers to feel stiffer and more painful. Some alternative supplements for joint pain should be avoided during pregnancy, including gamma-linolenic acid (GLA) and turmeric. One that's safe to try: Omega-3 fatty acids, which can be found in fish oil supplements or by eating salmon and other such foods. Omega-3s can help relieve pain and stiffness, plus have other benefits, like reducing premature births and promoting healthy brain development in your baby.
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  Pain-relieving creams and ointments

  Ben Gay, Icy Hot and other muscle creams can help sooth aching backs or other painful muscles—but you need to avoid these during pregnancy, especially during the third trimester. That's because the active ingredient in these is methyl salicylate, which is an NSAID. When you rub it on your skin, it can be absorbed into your body. Using it during the third trimester could harm your baby or cause bleeding in you or your baby during delivery.
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  CBD products

  Cannabidiol (CBD) products have become popular, with CBD creams and oils often recommended for joint and muscle pain. CBD is a chemical derived from marijuana, but does not contain its active ingredient (THC) and is not psychoactive. However, there hasn't been enough research on CBD products to know if they are safe for pregnant women. CBD may affect your hormones; plus, CBD products aren't regulated by the FDA and may contain THC or other contaminants. Marijuana use in pregnancy may cause miscarriage or affect a baby's brain development. Therefore, it's best to avoid CBD while pregnant.
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  Nonmedication alternatives

  To find relief from joint pain or lower back pain without medication, try improving your posture (both while standing and sitting), wearing low-heeled shoes, lifting properly (squatting, not bending), sleeping on your side (perhaps with a pillow between your legs), getting a prenatal massage, using hot or cold packs, and doing low-impact exercise like walking or swimming. Therapies like acupuncture and chiropractic may help too. (Check with your doctor first, though.)

Safe Pain Relief When Pregnant | Safe Pain Relievers in Pregnancy

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