Pregnant women may enjoy many of the aspects of carrying a child. But sciatica during pregnancy is likely not an experience anyone remembers fondly.
Sciatica is nerve pain as a result of an issue with the sciatic nerve. It affects an estimated 40 percent of people in the United States at some point in their lifetime. Pregnancy is a potential cause.
Here, learn everything you need to know about sciatica during pregnancy, including causes, risk factors, treatment options, and more.
What Is Sciatica During Pregnancy?
The sciatic nerve is the longest, thickest nerve in your body. Sciatica is characterized by pain that follows the nerve’s path. The pain may span the bottom half of your body, from your pelvis and down to your toes.
Research estimates around 40 percent of women will experience low back pain during pregnancy. However, true sciatica is more rarely the root cause of this pain. Other research on the prevalence of sciatica in pregnancy estimates it occurs in about 17 percent of pregnancies, with a higher likelihood during the third trimester.
Sometimes what seems like sciatica during pregnancy may actually be pain in the area of the sacroiliac (SI) joint — the joint where the sacrum, the triangular bone in the lower part of the spine, connects to the iliac bones, which are the large, winglike bones that form the upper portion of the pelvis.
G. Shaun Reynolds, a chiropractor based in Draper, Utah, says SI pain is much more common in pregnancy than sciatica. This is because during pregnancy the body produces relaxin, a hormone that loosens ligaments and tendons in the pelvis, in preparation for delivery. This leads to more motion — and less stability — than normal in the SI joint. It can cause a deep ache at the SI joint location that may radiate to the buttock, hip, groin, and back of the thigh.Exercises for spinal stability and stretching may help relieve SI joint pain during pregnancy.
Causes of Sciatica During Pregnancy
Changing hormone levels, along with mechanics — weight gain, shifting center of gravity, and stretched core muscles — can contribute to the development of sciatica during pregnancy.
Women can get mechanical irritation of the sciatic nerve from the change in body shape and size during pregnancy, according to Ai Mukai, MD, a physical medicine and rehabilitation physician in Austin, Texas. “Pregnancy hormones loosen the joints in preparation of birth, and this can cause a lot of shifting and stretching of the ligaments and joints of the pelvis, leading to sciatica,” she says.
Furthermore, the weight of the developing fetus puts pressure on the sciatic nerve, which runs under the uterus, down to the legs. That’s why pregnant women can feel sciatic pain in that area of the body.
“The symptoms are usually worse after the greatest weight gain, which typically occurs in the third trimester,” says Atul Patel, MD, a physical medicine and rehabilitation physician at the Kansas City Bone & Joint Clinic in Kansas.
The aforementioned factors associated with sciatica in pregnancy can affect any pregnant person. Additionally, the following risk factors may further predispose a person to developing sciatica:
Treating Sciatica in Pregnant Women
In the event sciatica does occur during pregnancy, physicians and patients typically want to be conservative with treatments — avoiding medication and unnecessary procedures, if possible.
Because it’s well known that sciatica can occur during pregnancy, most women understand it may just be part of the gestation process and try to cope as best they can without invasive treatments. They should still let their doctors know about the pain, though, according to the American Pregnancy Association.
A few strategies for naturally relieving sciatica during pregnancy include the following:
Getting ample rest
Lying down on the side of your body opposite the pain to help alleviate some of the pressure on the nerve
Avoiding heavy lifting
Not standing for long periods
Doing low-impact exercises, such as swimming
Applying hot or cold compresses to painful areas
Considering acupuncture
Wearing a maternity support belt
Booking a few sessions with a physical therapist to learn proper positioning techniques and how to transfer in and out of bed and in and out of chairs and vehicles, Dr. Patel suggests
More involved treatments aren’t off the table, especially for those who need them.
“If the pain is severe or she has neurologic findings (sensory changes or weakness), we can still perform a spinal injection to relieve pain, using ultrasound rather than X-ray guidance,” says David A. Spinner, DO, a physiatrist and director of pain management at White Plains Hospital in New York, who specializes in treating pregnant women who have sciatica.
However, Dr. Mukai says her first line of treatment is typically therapy-based. “I usually get patients into pelvic therapy with a certified pelvic therapist to work on looking at the pelvic floor function and teach techniques to try to self-correct alignment issues,” she says. “I also recommend a pregnancy support belt or an SI joint belt to help support the pelvis.”
According to the American Pregnancy Association, always contact your healthcare provider if the pain becomes constant, gets more frequent, or becomes more severe.
