Sciatica In Pregnancy: Causes, Treatment And Exercises

Wondering how to manage the severe sciatic nerve pain while you are pregnant? The first step to recovery is to know what is exactly causing the pain. In most of the cases, it is a problem that is associated with vertebrae since it puts pressure on the sciatic nerve. However, there are many other reasons as well.

Momjunction tells you what sciatica is, how you can identify it by its symptoms and get relief by doing some really easy stretch exercises.

What Is Sciatica?

Sciatica, also known as the lumbosacral radicular syndrome, refers to a group of problems. The sciatic nerve, which is the largest nerve in the body, runs from your lower back to the back of your legs and feet. This nerve sends sensation to the sole, lower part of the leg and back of the thigh (1).

Sciatic nerve pain is a recurrent throbbing pain throughout your legs. It originates from the lower spine and can be a deep, dull and shooting pain that radiates down the back of the leg. You can develop sciatica with or without a backache.

Can Pregnancy Cause Sciatica?

No, you will not develop sciatica just because you are pregnant. In fact, only 1% of pregnant women face this problem. (2) Contrary to the belief, sciatica is not caused due to the pressure put by your baby on the nerve. It usually happens due to damage to the disc of your spine that leads to swelling around the nerve.

Having a poor posture and staying inactive for long periods can also cause sciatica. Therefore, it is one more reason to remain active during pregnancy.

Lifting heavy objects or doing physically stressful activities during pregnancy will make your body vibrate, triggering sciatica.

The musculoskeletal pain that you experience at the anterior or posterior of the pelvic ring is not likely to be associated with the sciatic nerve. It is usually caused by the symphysis pubis dysfunction (SPD) or pelvic girdle pain (PGP) that is common during pregnancy and has the same symptoms as sciatica (3).

Possible Causes Of Sciatica During Pregnancy:

Physical activities and stress are the outer reasons for sciatica during pregnancy. But what happens inside your body? The typical causes of sciatic nerve pain when you are pregnant include:

  • Increased fluid retention and weight gain put pressure on the sciatic nerve that runs through the pelvis.
  • Growing uterus puts additional pressure on the spine and sciatic nerves (4) causing spinal disc herniation (rupture in the spinal disk which leaks out the gel).
  • Your expanding belly and breasts cause a change in the center of gravity and stretch your lordotic curve (the dip above the butt). This makes the muscles of your butt and pelvic region to tighten and press the sciatic nerve.
  • In the third trimester, when your baby starts shifting into a proper birth position, her head directly rests on the nerve, leading to severe pain in the butt, legs and back.
  • Systemic diseases such as diabetes can also affect sciatic nerve.
  • Tumor or abscess or bleeding in the pelvis can also harm the sciatic nerve.

Symptoms Of Sciatica During Pregnancy:

As aforementioned, the signs and symptoms of sciatica are almost similar to those of pelvic girdle pain (PGP) but are more severe. They can be constant or intermittent. Here are some of the common symptoms of sciatica:

  • A stabbing and burning pain which comes and goes mostly on one side but sometimes on both the sides.
  • Mild pain, originating from the butts or lower back area and spreading down the outer side of the calf to your foot and toes.
  • An occasional pain that may be widespread or patchy.
  • Tingling sensation in the leg along with numbness in your leg and foot.
  • A rare pain in the groin area.
  • Acute muscle cramps.
  • Abnormal curvature of the lower back.

The sciatic nerve pain that radiates down your buttocks and legs will be worse when it is accompanied by lower back pain.

Risk Factors Of Sciatica During Pregnancy:

Women are more prone to sciatica during pregnancy if they:

  • are overweight
  • smoke tobacco
  • are having back problems and osteoporosis

Also, if there is a pre-existing lower back issue, you are more likely to get sciatica because the nerve itself is very sensitive and may be affected by the baby’s weight that puts pressure on it.

Is There Any Way To Prevent Sciatica During Pregnancy?

There are no preventive measures for sciatica. Most gynecologists and spine specialists recommend:

  • An active and healthy lifestyle along with yoga or exercise to reduce the risk of nerve damage in your pregnancy.
  • Regular exercises to keep muscles healthy, thereby, enabling you to support the baby weight.
  • Not to overeat when you are trying to conceive and during the first trimester (early stages of pregnancy).

How To Manage Sciatica During Pregnancy?

Sciatica is a temporary discomfort, and you may treat the condition with some self-tips. A visit to a doctor is not needful if the pain is mild. Some of the effective home remedies for sciatic nerve pain are as follows.

  • Cover your skin with a cloth or flannel. Apply hot compress or an ice pack on the painful region. Alternating between warm and cold compresses helps relieve the pain. Do not leave the hot compress for long because raising your body temperature over 102.2 degrees is dangerous both to you and the baby (5).
  • Try to remain as active as you can. It is quite normal to feel a slight pain when you perform regular activities. However, you should know to adjust your pace.
  • Do not lift any heavy objects. If you have to lift heavy objects, first bend your knees, keep your back straight and try lifting the object by placing it close to the body.
  • When you are standing, keep your back in a slightly arched position. If you feel pressure when standing, lift one foot and rest it on some elevated object. While sitting, you can use a small cushion or a rolled towel to support your spine.
  • Listen to your body and refrain from doing anything that aggravates the pain.
  • Sleep on the side that is pain-free. If you feel the pain on the right side, sleep on the left. It will help in relieving the pressure on the nerve.
  • For a comfortable sleep, use a firm mattress that offers an excellent back support. Place a regular pillow or a pregnancy pillow in between your legs to support the pelvis and take off the pressure from the sciatic nerve.
  • To get on the bed, sit on the edge with your legs together and lie down on one side, and then pull your legs onto the bed.
  • When you are getting off the bed, roll towards one side and drop your feet and legs over the edge of the bed and slowly lift your body into a sitting position. It is better than directly getting up into a sitting position. You are less likely to trigger painful muscle spasms.
  • If you are working on a computer, take regular breaks.
  • Resting in the bed for longer periods will not help. Get off your feet and sit in a comfortable position to ease lower back and leg pain.
  • A gradual weight gain is advisable, as a sudden increase in pounds can put pressure on the sciatic nerve. If you were at a healthy BMI before pregnancy, try gaining only two pounds in the first trimester, around eight pounds in the second and 20 in the third trimester. A total weight gain of 30 pounds is ideal during pregnancy.
  • Wear flat or very low-heeled shoes. Do not wear footwear that is heavy as they put additional pressure on your lower back and legs.
  • Do not make jerky movements.
  • Swimming also works greatly in relieving the sciatic nerve pain. It takes off the pressure as the buoyancy of water relieves the spine from pregnancy weight temporarily.
  • Buy a girdle that lifts your uterus a bit. The girdle helps balance the weight proportionately and reduces sciatic pain.

If the above remedies do not help, and the pain becomes severe or constant, it is the right time to check with your healthcare provider.

Treatment For Sciatica During Pregnancy:

Your doctor may refer you to a musculoskeletal physiotherapist who specializes in women’s health.

A physiotherapist will recommend certain physical therapy exercises to strengthen your pelvic floor, back and tummy muscles. She may also ask you to wear a pregnancy support belt that fits below the baby bump and around the back. You will have to keep an eye on the functioning of your nerves throughout the pregnancy.

Your doctor may also advise pain medication for sciatica during pregnancy – paracetamol to ease the pain. Anti-inflammatory drugs like ibuprofen and acetaminophen (Tylenol) will also help. However, ibuprofen is not advisable if you are in your third trimester (6).

Also, these therapies can treat the sciatic pain:

  • Osteopathy
  • Acupuncture/Chinese medicine
  • Chiropractic
  • Massage

Getting a prenatal massage, especially in your second and third trimesters, by a specialist will help. It will not only relieve pain but also help you sleep better. It significantly alleviates the symptoms of sciatica and boosts blood circulation.

Make sure you get these therapies done by a registered practitioner, who has experience in dealing with pregnant women.

Effective Stretches For Sciatic Pain Relief During Pregnancy:

Performing regular exercises and yoga stretches help manage the pain by strengthening your spine, hips, pelvic floor, stomach, and back. Yoga helps to correct your posture and enables stretching. In case you have persistent sciatica, you need to continue the exercises even after delivery. The generally recommended exercises include:

1. Seated Piriformis Stretch:

The piriformis muscle is the lateral rotator of the leg, situated deep in the buttocks. When tight, it will cause irritation in the sciatic nerve. The seated piriformis stretch helps to relieve tension in this muscle and subside the sciatic nerve pain.

How to do:

  • Sit on the edge of a chair. Straighten your back and relax your shoulders.
  • Raise the left foot and place your left ankle on your right knee.
  • Put your left hand on the left knee so as to prevent from lifting your leg during the stretch.
  • Lean forward towards your knees until you feel a stretch in your left buttock.
  • Hold for 45 seconds and repeat with the other leg.
  • You can repeat this exercise several times in a day.

2. Table Stretch:

This is another active stretch which helps relieve the muscles of the back, buttocks, and legs. It stretches the lumbar spinal segments and flattens the spine.

How to do:

  • Stand near a table with your feet placed a hip-width apart.
  • Lean forward by putting your hands on the table. Let your arms be straight and back flat.
  • Try pulling your hips away from the table until you feel a stretch in the back of the legs and lower back.
  • Remain in this position for 30 seconds to one minute and then stand up straight.
  • Repeat this exercise twice a day.

3. Pigeon Pose (Kapotasana):

Pigeon Pose

This is another effective yoga pose which helps relieve sciatic pain during pregnancy. With a few changes, it can be easily performed in your pregnancy.

How to do:

  • Kneel down on the ground.
  • Extend your left leg behind you as much as you can.
  • Bring your right foot forward folding the knee to the side. Your shin should be in a horizontal line in front of your body.
  • Bring in a yoga block beneath your hips. It helps lessen the intensity of the stretch and allows room for your tummy.
  • Lean forward towards the front leg.
  • Gradually bend towards the ground, placing a pillow underneath your head and arms for support.
  • Remain in this position for one minute and repeat on the other side.
  • You can repeat this exercise several times a day.

4. Hip Flexor Stretch:

Hip Flexor Stretch

Hip flexor muscles run through the front of the hip and help in forward movement of the leg as in walking. These muscles become tight during pregnancy, affecting the pelvic floor, and thereby causing pain.

How to do:

  • Kneel down on the ground.
  • Step one foot forward so that the hip and knee are placed at a 90-degree angle.
  • Put all your weight forward until you can feel a stretch in the back, hip and leg.
  • Remain in this position for 30 seconds and repeat with the other side.

5. Glute and Hamstring Foam Rolling:

Glute and Hamstring Foam Rolling

Foam rolling is one such great ways to help sciatica, it relaxes and soothes the tight muscles. The foam roller acts as a mini massage for tight muscles and connective tissue.

How to do:

  • Keep a foam roller on the floor.
  • Sit on the roller by supporting with your hands behind you.
  • Raise one foot and place it on the other knee.
  • Move your body back and forth until you feel a tender spot.
  • Continue the movement over the sore area for about 30 seconds to one minute.
  • Now roll down the foam to the back of the upper leg until you find another tender spot.
  • Repeat the same with another side.

6. Torso Twist:

Torso Twist

The torso twist stretches your sciatic nerve without causing extra pressure on the body. It can also be performed by sitting down, as you are at no risk of falling and hurting your baby.

How to do:

  • Take a comfortable chair. Sit straight with the back of the chair on your right side.
  • Breathe deeply and steadily by holding onto the back edge of the chair.
  • Twist your torso to the right by pushing yourself on the back of the chair gently.
  • Remain in this position for 30 seconds and repeat the same with your left side.

7. Tailor Sitting:

Tailor Sitting

Tailor sitting is ideal for stretching and strengthening the muscles of the lower back, thighs, and pelvis, as well as the sciatic nerve.

How to do:

  • Sit on the floor with your legs bent and feet placed together.
  • Move forward so as to relieve pressure on your back.
  • Keep your hands on the knees to provide mild resistance, and flex your knees up and down.

8. Pelvic Tilts:

Pelvic Tilts

Pelvic tilts work on the lower back to relieve tension, as well as relax and loosen the abdominal muscles. Therefore, the stress and pressure are released from the lower back, which is otherwise the main contributor to the sciatic pain.

How to do:

  • Lie on your back on the ground.
  • Raise your knees until the feet are flat.
  • Slowly tighten the abdominal muscles and push the lower back onto the floor.
  • Remain in this position for some time and relax.
  • Repeat it two times a day with at least five sets each time.

9. Knee Pulls:

Knee Pulls

A variation of the knee exercise, this is a simple exercise to stretch the sciatic nerve.

How to do:

  • Lie on your back on a mat or the bed.
  • Raise your right knee towards your tummy.
  • Put your hands on the knee and try pulling your leg as much as you can without putting any pressure on your abdomen.
  • Now practice with the left knee. You can also try with both legs at the same time.

10. Thigh Stretch:

This is an optimum stretch for upper thighs and lower back which helps ease out the sciatic nerve pain.

How to do:

  • Sit with your back straight on a simple wooden chair.
  • Stretch the painless leg and make it touch the floor firmly.
  • Now raise the leg with sciatica pain and slowly place it beneath the knee of your painless leg. Slowly move forward towards the painless foot and hold the position for few seconds.
  • While moving the body forward, keep your back straight.

11. Chest Stretch:

The chest stretch strengthens the chest and neck muscles and reduces sciatica pain.

How to do:

  • Stand between two walls or the entrance of your room.
  • Put both your hands on the walls. The hands and forearms should touch the walls completely.
  • Keep both the hands at your chest level and the elbows slightly bent.
  • Move your entire body forward and then bring back to the earlier position.

12. Standing Calf Stretch:

The standing calf stretch prevents leg or foot cramps due to sciatica.

How to do:

  • Stand on your feet and turn your body to face a wall.
  • Keep your left foot close to the wall and the right foot two feet away from the wall.
  • Place the hands and forearms on the wall. Keep the elbows at your shoulder’s height.
  • Bend your left knee so that the body moves forward.
  • Try to stretch your body, as much as possible. It would seem that you are trying to push the wall. Hold the position and then release.
  • Continue the same thing with another leg.

13. Child Pose:

Child Pose

Child pose is a simple stretching exercise, which stretches the lower back portion and the rib cage of the body.

How to do:

  • Sit erect on the floor and bend your knees.
  • Place your lower back or buttocks on your heels.
  • Now stretch both your hands on the floor and bend down your head. Remain in the posture for about two minutes and gradually return to the earlier position.

14. Knees Rocking:

Knee rocking is the ultimate appeasing exercise used in back pain relief programs. It relieves the engorgement of fluid around the facet joints (located between and behind the vertebrae), thereby lessening the pressure and reducing the pain radiating down the leg.

How to do:

  • Lie on your back, preferably on the bed or any soft surface.
  • Arch your lower back so that the navel sucks in hard. You may use your hand to push your tummy inside.
  • Putting another hand behind the thigh, try getting one leg towards your chest. Now use both your hands to pull the other leg near the chest.
  • Place a hand on each knee and get back your legs so that your thighs rest at an angle of 90º.
  • Gently oscillate your legs in this position.
  • If your hips are tight, cross your ankles and place your wrists across upper shins and then oscillate remaining in this position.

15. The Preparatory Nerve Root Stretch:

This exercise releases the nerve gently by coaxing it from the inflamed facet joint. It makes you dig into the pain to a degree where the tension is pleasing.

How to do:

  • Lie on your back.
  • Fold your painful leg behind the thigh and bring your knee towards your chest.
  • Now straighten your leg gently so that your heel faces the ceiling.
  • The tension of the sciatic nerves goes up as you push your heel, and you can sense a painful pull in your leg.
  • Do not panic and hold your leg as high as you can for about five seconds.
  • Now release and repeat it.
  • You can also try with another leg, and feel the pain leaving, as your feet goes high.

16. Curl-Ups:

This exercise strengthens the lower abs.

How to do:

  • Lie on your back and bend your knees.
  • Fold your arms across the chest or keep them beneath your head for supporting the neck.
  • Now curl up your body by raising your head and shoulders off from the surface.
  • Hold this position for two to five seconds and slowly release back to the starting position.
  • Perform 10 to 12 curl ups a day and gradually increase it to 20.

While doing the above stretches, never stretch beyond the pain point. Stop the stretch if you feel the pain is getting worse. It is always better to consult your physician before starting these exercises. If you experience any symptoms such as headaches, dizziness or bleeding, refrain from exercising and check with a doctor.

Will Sciatica Affect Your Labor?

If sciatic pain limits some labor positions, then your physiotherapist may advise a position that makes labor easy. A birth pool is helpful as it makes the movements easier.

Sometimes, though you may not have sciatica during pregnancy, you are likely to develop the pain postpartum if the sciatic nerve is injured during the labor. Sciatica post pregnancy is very common which is mostly attributed to the pressure generated by the massive power of uterus. There are high chances especially after a prolonged labor.

Also, experiencing sciatic pain in one pregnancy is not an indication that you will get it again in your subsequent pregnancy.

How Long Does Sciatic Nerve Pain Last During Pregnancy?

In most cases, sciatica symptoms lessen within six weeks after delivery while a few may take about 12 weeks. In cases where the pain is severe, mild symptoms remain for six months to years (sometimes) after delivery.

Does Sciatica Make Caring For Baby Difficult?

Any condition about your back can be problematic while you are caring your little one. You should maintain the right posture and try different positions while breastfeeding.

  • Lie on one side with the painful side facing up. It can relieve the pressure on the spine and help reduce the pain.
  • Laid-back breastfeeding is also helpful.
  • When you are in a sitting position, choose a straight-backed chair and let your feet be flat on the floor. Place your baby on a cushion or a pillow so as to raise her to your breast level.
  • While you lift your baby, ensure your back is straight and knees bent. Avoid any twisting movements.

Have you experienced sciatica during pregnancy? What did you do to get relief? Share your story with other mommies here.

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