# Pain management after treatment and/or ttc



## Val74 (Jan 3, 2015)

Hi everyone, looking to see how anyone with pain issues copes. I have condition where my shoulder traps my nerves and sinews and causes really bad pain in my shoulder, arm and neck which can flare up and  make it worse. Had iui on the weekend and am struggling with the pain and newly developing headaches. Usually I manage the pain with cocodamol but am worried about using it, been using paracetamol but they're hardly even touching the headaches let alone my shoulder and arm 'toothache'  ; any tips?


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## CrazyHorse (May 8, 2014)

Cocodamol is what a perinatologist (maternal/fetal medicine specialist) recommended to me years ago as a first-line treatment for migraine when pregnant. There appears to be a statistically significant increase in certain birth defects, mainly heart defects, associated with opioid use in pregnancy: http://www.ajog.org/article/S0002-9378(10)02524-X/fulltext. However, the absolute risk of such defects remains quite small even with opioid use. While the study I've linked here got enormous play in the American media, the authors acknowledge that there are significant limitations to their methodology, particularly the fact that about a third of study subjects did not respond to questions, and the fact that dose-response relationship was not assessed (i.e., they didn't distinguish between someone who takes a few cocodamol and someone who takes high-dose Oxycontin daily).

Especially given that you're not even confirmed as pregnant yet, if I were in your shoes, I would continue with my pain medication as normal, and just make sure I didn't take any more than was absolutely necessary for reasonable pain control. I'd also make sure I thoroughly used whatever non-drug interventions (e.g., hot/cold packs) might provide pain relief prior to breaking out the cocodamol. That's what I've been doing for headaches the last few days.

Only you can make a decision about what level of risk that you are comfortable with, so it really is worth taking some time to research the available data on birth defects -- it's just a shame the quality of evidence is so poor!

/links


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## Val74 (Jan 3, 2015)

Thanks crazyhorse, will have a read through that. Know what you're saying though, advice around it is so conflicting. I've stuck to paracetamol, a massager and old physio exercises for the time being. Thankfully the headaches are starting to ease a little as they were driving me even more   as am so not used to them. Am hoping I can last it out or if really bad a couple now and then but will check again with clinic first. I don't want to do anything that may risk me not getting pregnant or impacting if I am; just hope I don't have a major flare up. Thanks again, Val xx


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## Val74 (Jan 3, 2015)

Oh and Congrats on your BFP!!   xx


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