The RA Pregnancy Chronicles: Pregnancy-Safe RA Relief

The RA Pregnancy Chronicles is a series of posts that share my experiences being pregnant while living with RA. This post was written during Week 14 of my second pregnancy

RA pain is never fun. Period. But these days I am finding my RA symptoms to be even more frustrating because I have so few options for addressing my aches and pains while I am pregnant.

Recently, in addition to wicked morning sickness, I have also been dealing with terrible morning stiffness. I wake up in the morning feeling like my body has been run over by a bus several times during the night. It hurts to move. It hurts to stay still. Every limb feels heavy and I don’t feel like I have enough energy to even get out of bed, let alone start my day. Then I hear my son cry and I know I have to get moving. Somehow I manage, but it isn’t easy! And some days the pain and stiffness lasts most of the day.

Unfortunately, most of the things that I usually do to deal with RA pain just aren’t safe to do while I am pregnant. So I have been brainstorming what I can do instead and I wanted to share my ideas here!

Medications

• Usually when I am dealing with RA pain I take over-the-counter nonsterodial anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil) or naproxen (Aleve). These medications work to combat inflammation in my joints and relieve my pain. Unfortunately, these medications are generally not recommended for use during pregnancy. Sometimes a doctor will approve their use, but only during the early stages of pregnancy. During the third trimester the use of NSAIDs may result in birth defects. So consult your doctor before taking any NSAIDs.
• While I am pregnant there are far fewer options for medication. One option is acetaminophen (Tylenol), which in the past has been routinely approved for all stages of pregnancy for pain relief (or fever). However, a recent study has shown that children whose mothers took acetaminophen while pregnant were more likely to develop ADHD. While additional study is necessary to determine a direct causal link, the study serves as a good reminder that any medication I take while pregnant has the potential to impact my baby.
  In any event, I do not find Tylenol to be that effective in controlling my RA pain anyway!  I always try not to take additional medications while pregnant, but I do know that if I am really struggling I can ask my rheumatologist to inject cortisone directly into a particular joint or give me a prescription for prednisone.  I ended up needing to use some prednisone at the end of my first pregnancy to deal with some intense joint pain in my hips. Of course it would be better not to need any medication at all, but dealing with RA and pregnancy is always a balancing act.

Soaking

• Usually I like to soak in the hot tub when my joints (and muscles) are painful. Letting my body melt into the hot water for a while is an amazing way to deal with pain! But unfortunately it isn’t safe to soak in a hot tub when you are pregnant. Sitting in hot water that stays hot raises your body temperature, which also raises the baby’s body temperature, and that isn’t safe. So the hot tub is out.
• While I am pregnant I like to take a warm bath. Bathwater is warm enough to give my joints and muscles a little bit of relief, but it also cools relatively quickly so it doesn’t raise your body temperature the same way sitting in a hot tub does. For added benefit I like to put Epsom salts in my bath. Epsom salts are made from magnesium sulfate, and when that mineral is absorbed through the skin it draws toxins from the body, sedates the nervous system, reduces swelling, relaxes muscles, and more. Magnesium sulfate has been assigned to pregnancy category A by the FDA so it is safe to soak in while pregnant. While you are in the bath it is still a good idea to make sure you drink cool water to make sure you stay hydrated and don’t overheat.

Massage

• Usually I find therapeutic massage to be very helpful when I am dealing with RA pain, particularly because joint pain often leads to muscle pain. Luckily massage is still an option!
• While I am pregnant I like to get prenatal massages, which are a little bit different than an ordinary massage because you lay on your side supported by pillows rather than laying on your stomach. It is important to make sure you find a certified prenatal massage therapist who has received training in how to address specific pregnancy massage needs. These certified therapists know to avoid pressure points on the ankles and wrists that can sometimes stimulate the uterus.

Luckily, there are still some options for dealing with RA flares during pregnancy. Still, I haven’t managed to find a suitable replacement for one of my favorite options – drinking a relaxing glass of wine! Guess that one will just have to wait a few more months!