Back Pain During Pregnancy: What You Need to Know

Question
Hello,  I am 28 years old and just found out I was pregnant about a week ago.  My last period started on Christmas Eve and this is my first pregnancy.  I am in a predicament.  I have had 4 major lumbar surgeries in the past 8 years with the last one an interbody fusion of L4-S1. (back in 10/01)  A week after I became pregnant, I "threw out my back" at work.  I had no idea that I was pregnant and went to my Doc.  They did X-rays and gave me injections to ease the muscles and nerves in my back.  I had increased my Lortab usage as well.  Now I am worried about everything I did during the first 3-4 weeks. Since then, I have stopped taking pain killers, but I am miserable with pain and can hardly sit to write this letter to you because of the nerves in my lower back.  My question is I have heard that Lortabs can be taken during pregnancy.  Is this true?  Do I have to find a special OB/GYN that knows how to deal with back problems?  Any info would be greatly appreciated.  Thanks,  Mariam

Answer
Lortabs (hydrocodone/Tyleno) are a category C medication and can be safely used during pregnancy. No evidence of teratological effects have been found with its use. If you have pain due to your back problems, you can continue to use the pain medications. You do not have to see a specialist due to your previous surgery. However, you should have a consultation with an anesthesilogist in preparation for delivery in order to discuss alternatives in anesthesia during labor (Epidural, Spinal, local). If you must delivery via cesarean section, your previous surgery may have implications as far as the method of anesthesia you can have.  There is no way to know if the X-rays you had in early pregnancy caused any ill effects to the fetus. Probably not.However, there is nothing to do about it at this time. Good Luck with the rest of the pregnancy. You may try Percocet, Tylenol with codeine, or continue the Lortabs, if they alleviate your discomfort.