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Sciatica in Pregnancy: Symptoms, Causes and Treatment

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Women may experience sciatica from pregnancy due to the compression of the sciatic nerve by the growing fetus. The sciatic nerve goes through the buttocks and down the legs. Sciatica is a condition where you develop shooting pain down the legs due to the compression of the sciatic nerve (1).

Although back pain may be common during pregnancy, sciatica is usually uncommon, affecting about 1% of pregnant women (2). Sciatica may usually be acute for most women. The condition is treatable, and you may even consider some simple exercises to feel better. Sciatica usually goes away after delivery (3).

Read this post to know the various symptoms, causes, management techniques, and gentle exercises for sciatica during pregnancy.

Causes Of Sciatica During Pregnancy

Pressure on the sciatic nerve from a herniated disc of the spine is the most common cause of pain across the sciatic nerve path. During pregnancy, the growing baby and the expanding uterus may put pressure on the sciatica nerve. Sciatica pain is more common during the third trimester when the uterus and baby get bigger, causing pressure on the sciatica nerve (4).

Sciatica may also occur for the following reasons (4) (5).

  • Obesity
  • Poor posture
  • Piriformis muscles spasm in the buttocks
  • Slipped disc
  • Blood clots
  • Abscess
  • Tumors
  • Other nerve disorders

Risk Factors Of Sciatic Pain During Pregnancy

The following factors may make a woman more susceptible to sciatica pain during pregnancy (6).

  • Being overweight

Being overweight before pregnancy or gaining additional weight on the front during pregnancy puts a lot of strain on the spinal cord and the back muscles. It can lead to back strains and back pains.

  • Pre-existing lower back pain (LBP)

Pregnant women with a history of back pain before pregnancy are at an increased risk of experiencing sciatica during pregnancy. Pregnancy hormones cause an increased laxity of ligaments, muscles, and joints during pregnancy, making one more susceptible to sciatica (7).

  • An injury

A previous injury or a new injury during pregnancy can lead to sciatica. The pain from a previous injury may resurface as the center of gravity changes during pregnancy and leads to sciatica (7).

  • Have a weak core

The abdominal and back muscles collectively form the core of the human body. Women with a weak core prior to pregnancy may have more chances of developing sciatica as the baby, uterus, and breasts grow in size and weight.

  • History of diabetes

Diabetes can increase chances of nerve damage which in turn may increase the chances of sciatica.

  • Osteoarthritis

Osteoarthritis damages the spine and puts nerves at an increased risk of injuries.

  • Sedentary lifestyle

A sedentary lifestyle can cause muscle weakness, and in turn, an increased susceptibility to sciatica.

  • Tobacco

The nicotine present in the tobacco can damage the spinal cord, weaken the bones, and may cause wear and tear of the vertebral discs, leading to sciatica in pregnant women.

  • Vitamin B12 deficiency

Vitamin B12 plays an important role in maintaining nerve health. Vitamin B12 deficiency can therefore lead to sciatica (8).

Symptoms Of Sciatica During Pregnancy

The main symptom of sciatic pain in pregnancy is pain that starts in the lower back and spreads down to your legs. The following symptoms may also accompany (4).

  • Leg pain
  • Poor bladder control
  • Burning sensation in the legs
  • Pain that exacerbates with coughing, moving, or sneezing 

If you notice these symptoms, you should inform your healthcare provider about them. They can prescribe you some medicines or suggest ways to ease your discomfort. It is suggested to avoid OTC drugs without the doctor’s consent during pregnancy.

Diagnosis Of Sciatica In Pregnancy

The diagnosis of sciatica during pregnancy is made mainly based on the symptoms and medical history. The usual tests for diagnosis of sciatica are X-rays, MRIs, electromyography, and nerve conduction studies (5). However, diagnostic tests, including X-rays, and MRIs are unsafe during pregnancy. Therefore, the doctor will weigh the risks and benefits before using any diagnostic tools to confirm sciatica in pregnancy.

Treatment For Sciatica During Pregnancy

Your healthcare provider may advise physiotherapy for you. Ensure your therapist knows about your pregnancy and suggests safe exercises. Your physical therapist can also help you balance your posture and improve your weight-bearing capacity. These exercises can help you find some relief from the sciatica pain and also help in strengthening your abdominal, back, and pelvic floor muscles (6).

Support belts and corsets can help you achieve good back support. In addition, they can be effective in relieving back pain (9).

Other non-pharmacological modes such as acupuncture, manual therapy, water therapy, transcutaneous nerve stimulation, yoga, and other alternative medical treatments may work for some women. However, you should consult your Obstetrician-Gynecologist (OB-GYN) before choosing any treatment modalities to ensure your and the baby’s safety (10).

Home Care For Sciatica In Pregnancy

The following tips can help you manage the symptoms of sciatica at home (1) (4) (6).

  • Cold or warm compresses to the affected area can ease pain and swelling by reducing tension in these
  • OTC medicines such as acetaminophen can help reduce inflammation and pain.
  • Gentle stretching exercises help in muscle strengthening and pain
  • The most effective remedy for sciatic nerve pain while pregnant is to lie on the opposite side of
  • Swimming also helps ease the discomfort.
  • Getting a gentle massage from a masseuse (trained to perform pregnancy-safe massages ) can help relieve inflammation and discomfort around the sciatic nerve.
  • Laying on the back while rolling on a tennis ball or a foam roller kept under the lower back can help in reducing the pain and muscle tension.
  • If you are into a desk job, taking short, frequent walks between work can help relax muscles and also reduce the tension in these
  • Maintain correct posture by sitting on ergonomic chairs to avoid slouching and resulting problems.
  • Warm baths can also help in giving some relief.
  • Do not stand for long hours. If you experience pressure while standing, you may try resting one foot on an ottoman or stool. 

Effective Stretches For Sciatic Pain Relief During Pregnancy

Back stretching is a great way to relieve sciatic nerve pain. However, avoid stretching exercises that involve lying on your back as it may cause the uterus to exert pressure on the vein, leading to the heart. In addition, it can make you feel weak or cause lightheadedness.

1. Seated piriformis stretch

It is a muscle located deep in the glutes, and spasms in these muscles may lead to sciatica pain.

Steps (4):  

  • Sit in a chair with your feet placed flat on the floor.
  • Lift your right leg, and keep your right ankle on the left knee.
  • Gradually, lean forward while keeping the back straight.
  • You will feel the stretch in your glutes and the lower back.
  • Hold the position for 30 seconds.
  • Repeat the same posture with the left leg. 

2. Child’s pose

This pose gives a good stretch to the muscles of the back and the thigh.

Steps (4):

  • Kneel on a soft surface, such as a carpet or a yoga mat.
  • Bring your big toes together and spread your knees apart to make room for the belly.
  • Rest your forehead on the floor while keeping the back straight.
  • Spread your arms straight to the front as you inhale.
  • As you exhale, bring your bottom towards your heels and sit back on your legs.
  • Keep taking deep breaths as you stretch your arms forward with each breath.
  • Walk your hands back slowly to come back to the kneeling

3. Standing hamstring stretch

This exercise will help you strengthen and add flexibility to in the muscles surrounding the sciatica nerve, and it will reduce irritation of the sciatica nerve.

Steps (4):

  • Stand upright with both feet firmly pressed against the ground.
  • Raise your right leg and place it on a fixed object, such as a bench, a footstool, or a
  • Keep your leg straight with the toes pointing upward.
  • Gently bend forward until you feel a good stretch in the hamstring.
  • Hold the position for 30 seconds.
  • Repeat the same with the left leg.

Preventing Sciatica During Pregnancy

The following measures may be helpful in preventing sciatic pain.

  • Try to reach a healthy weight range or BMI before you plan to conceive.
  • Maintain correct posture in your day-to-day life while standing, sitting, or walking to avoid additional stress on the
  • Try to get enough rest whenever possible.
  • Stay active and indulge in safe exercises as allowed by your doctor.
  • Wear supportive shoes to avoid added stress to your back.
  • Use pillows to support your belly and back while sleeping to avoid extra strain on the back.
  • Roll on to your side before getting up from the lying
  • Avoid smoking.

Back pain in pregnancy can occur for various other reasons as well. You can read more about the causes and management of back pain in pregnancy here.

Sciatica pain can be frustrating. While it most often resolves a few days after childbirth. However, you may have to make some adjustments while taking care of caring for your baby. You may want to try breastfeeding them while you are lying down or shift place the changing station on a countertop rather than the floor. Whenever you lift the baby or place them in the crib, try keeping the back straight and bend your knees to avoid additional stress on your back. Postpartum massages, gentle stretching, exercises, and brisk walking can help you manage your sciatica.

References:

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Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. Dr. Shah's deep interest in the well-being of babies and children... more