Treating Fibromyalgia Pain During Pregnancy: Medication Risks

Fibromyalgia is a chronic condition characterized by musculoskeletal pain as well as fatigue, sleep, memory and mood issues. According to the Mayo Clinic, researchers believe that fibromyalgia exacerbates painful sensations that affect the way the brain processes pain signals.

The medication Gabapentin (Neurontin) — an anticonvulsant and analgesic originally developed to treat epilepsy – is commonly prescribed for the treatment of fibromyalgia, though whether to continue taking Gabapentin during pregnancy is a decision each expectant mother with fibromyalgia must make.

In addition to fibromyalgia, Gabapentin also is used to treat nerve pain caused by shingles, diabetic neuropathy, peripheral neuropathy, trigeminal neuralgia, multiple sclerosis and sciatic nerve pain as well as for off-label purposes such as restless leg syndrome, anxiety disorders, insomnia and bipolar disorder.

There are current investigations looking into whether Gabapentin causes birth defects, a risk that was not adequately warned about on the medication’s warning label.

Some of the congenital birth defects associated with anticonvulsant medications include cleft palate, craniosynostosis (skull malformations), bone malformations, heart defects, hydroureter and/or hydronephrosis, hypospadias (an abnormality in the opening of the urethra in boys), polydactyly (extra fingers or toes) and spina bifida.

There are few medications approved for use during pregnancy and the risks to the mother and fetus are often unknowns since many medications are not tested on pregnant women. Medical professionals have long recommended that women ingest as few medications as possible during pregnancy. The controversy over pregnancy and fibromyalgia is no different.

A study of pregnant fibromyalgia patients showed that these women gave birth to smaller babies, had abnormal blood sugar and amniotic fluid levels and about 10 percent of them suffered recurrent miscarriages.

Dr. Kevin White, a retired chronic pain specialist, offered various suggestions to Healthline.com for coping with fibromyalgia during pregnancy, which include stretching, meditation, yoga, deep heat ointments and massage, so long as it’s not too “aggressive.”

“Pool therapy or sitting in a hot tub may be particularly soothing — especially for those with back pain and in the late stages of pregnancy,” according to the website. “Exercise is important as well, but it must be tailored to individual ability and endurance. Being in a pool during exercise may help.

“Rest is crucial. Even healthy pregnant women often find the need to sit or lie down to relieve pressure on their back and legs. Schedule 20- to 30-minute breaks throughout the day.”

White suggests taking adequate – even extended — leave from work to ensure the expectant mother receives sufficient rest.

Following the baby’s birth, White says the mother’s fibromyalgia typically will worsen, a phenomenon that likely occurs as the result of sleep deprivation.

“Fibromyalgia sufferers typically have very disrupted sleep,” said White. “And research has shown that the worse they sleep, the more pain they have, especially in the morning.

“It’s no coincidence that the mother’s fibromyalgia generally doesn’t start returning to baseline until after the baby starts sleeping better. It’s also crucial that a mother’s mood is followed closely, since post-partum depression can be missed or misinterpreted as fibromyalgia.”

Gabapentin (Neurontin) Birth Defects Investigation

Women who took Gabapentin or Neurontin while pregnant and had a baby with a birth defect may have a legal claim. Lawyers are investigating claims that the drug manufacturer did not do enough to warn women of the risks of birth defects from taking these drugs.