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Degenerative Disc Disease and Pain Management

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  • #1

    Degenerative Disc Disease and Pain Management

    I was recently diagnosed with degenerative disc disease and my orthopedist is unsure as to what pain medication to prescribe that would be compatible with breastfeeding. I have a full-term three month old who weighs approx 14 lbs. I have tried acetaminophen, ibuprofen (which irritates my stomach), and Lidoderm patches, none of which effectively take my pain away. I also tried Baclofen, which is apparently the only muscle relaxer that's allowed and also doesn't help. Nobody seems to want to make recommendations, including my pediatrician, OB, pharmacist, and primary care provider. I would appreciate any input. Thank you.
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  • #2
    Dear Snowie,

    Celecoxib (Celebrex) is a nonsteroidal analgesic and a good choice during breastfeeding as minimal amounts are found in breastmilk. To decrease the amount of medication your infant is exposed to, breastfeed first then take your dose. Observe for vomiting and diarrhea in your infant although not likely to occur since minimal amounts appear in breastmilk. Diclofenac (Voltaren) is an ointment applied to the skin that is a nonsteroidal analgesic that relieves pain but since applied topically wouldn't irritate your stomach. Reported levels would be too low to affect a breastfeeding infant. Tramadol is similar to the opiates, but appears to be less addicting. Minimal amounts are found in breastmilk and thus is compatible with breastfeeding. Observe your infant for sedation. Hydrocodone also has minimal amounts in breastmilk but has the potential for addiction if taken long term. Your infant should be weaned slowly to avoid withdrawal symptoms if this medication is used long term. Also observe for sedation. Once you and your physician decide on the best choice of medication for your particular situation, call us at the InfantRisk Center. Our phone number is 806-352-2519. We are open Monday through Friday, 8 to 5 CDT. We can discuss the time the medication is highest and how long the medication would be in your system to reduce risk to your infant.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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