Sciatica in pregnancy: symptoms.  Causes and Treatment

Back pain during pregnancy is quite common and is often due to the carrying of extra weight on the front of the body. But while it’s normal to experience pain in the middle of your back or buttocks, some people will struggle with a painful condition called sciatica.

Sciatica causes sharp, stabbing pain that starts in the lower back or buttocks and spreads to the back of the legs. This happens because the sciatic nerve – the largest nerve in the body – becomes compressed or irritated.

The incidence of sciatica will increase as pregnancy progresses. Sciatica is more common in the third trimester. Fortunately, sciatica is a temporary condition that often resolves after birth.

Learn more about sciatica, including its signs and symptoms, causes, treatment, and when to see your doctor.

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Symptoms

Back pain during pregnancy is a common symptom and can affect your quality of life. Sciatica, on the other hand, is less common and affects 1% of pregnant women.

On each side of your body, your sciatic nerve starts in your lumbar spine (lower spine), runs into your buttocks, extends into the back of your thigh, and ends just above the hollow of your knee. Your sciatic nerve then extends into other nerves that continue into your leg, foot, and toe.

Sciatica-related pain is dull, deep, or sharp. It can range from easy to difficult. But the pain is manageable and can go away with treatment.

Additional symptoms of sciatica include:

  • Pain traveling down the leg
  • Numbness or weakness in the lower back, buttocks, leg, or foot
  • Pain that worsens with movement or limited movement (e.g. sitting or lying down for long periods of time)
  • A “tingling sensation” in the legs, feet or toes
  • Difficulty walking, standing, or sitting for long periods of time

causes

Sciatic nerve pain is generally caused by problems in the lumbar spine, such as a bulging or herniated disc. It can also be caused by a bone disease that affects the spine, such as spinal canal stenosis, spondylolisthesis, or osteoarthritis. These conditions can put pressure on the sciatic nerve, causing symptoms.

During pregnancy, sciatic symptoms unrelated to another condition can be caused by muscle tension and unstable joints. This is the action of a hormone called relaxin that is amplified during pregnancy.

Relaxin prepares the pelvis for labor by relaxing the ligaments and expanding the hips. As the pregnant belly grows and the ligaments loosen, the center of gravity shifts, irritating or pinching the sciatic nerve.

The baby’s weight can also increase the pressure already on the pelvis and hip joints. In some cases, the baby’s position in the uterus can put pressure on the sciatic nerve.

treatment

Treatment for sciatica during pregnancy includes a variety of self-treatment therapies. This can include massages, stretches, gentle exercises, heat and cold therapy, pregnancy belts, and practicing good posture. Medical therapies are rarely considered during pregnancy.

massage

Prenatal massage can help relieve pain, inflammation, and discomfort in the back and other areas of the body affected by the sciatic nerve. When looking for a masseuse, it is best to find someone who specializes or has experience in pregnancy massage. The massage movements should be light and the masseuse should stop if there is pain or significant pressure.

strain

Gentle stretching during pregnancy can strengthen your back and abdominal muscles to reduce back pain and stiffness. Light stretching can also relax tight muscles and relieve sciatic nerve pain.

The American College of Obstetricians and Gynecologists recommends avoiding exercises that require you to stand still or lie flat on your back. Lying on your back puts pressure on the large vein in the uterus that carries blood back to the heart. If you stand motionless, your legs and feet can be supplied with blood. Either position can also lead to a drop in blood pressure.

Safe exercises

Fast walking, biking, yoga, and swimming are all safe ways to get exercise during pregnancy. Swimming, in particular, can help support the weight of your pregnant belly and reduce pressure on joints and muscles.

You should always speak with your doctor to make sure certain exercises are safe for you during pregnancy.

Heat and cold therapy

Cold therapy can reduce pain and swelling. Apply an ice pack or bag of frozen vegetables wrapped in a towel to the painful area. Apply for 20 minutes several times a day.

After a few days of cold therapy, you can switch to a heating pad. Apply for 20 minutes at a time.

You can switch between hot and cold depending on what improves symptoms. Do not apply a cooling pad or heating pad to your stomach or back for more than 20 minutes.

Maternity support clothing

Some research suggests that wearing maternity clothing (such as a pelvic belt) may help relieve sciatic nerve pain. This support garment works because it evenly distributes pregnancy weight and supports posture.

A 2019 systematic review examined studies that support the use of maternity wear to relieve pain in the lower back and pelvic girdle. The review found that using the garments can help relieve pain, improve balance, reduce falls, and improve function and mobility during pregnancy. The types of support garments studied were those that are commercially available.

Practice good posture

Make a habit of maintaining good posture while sitting, especially when using a computer. Try not to slump or laze around. Placing a support pillow behind your back can help you sit more comfortably and reduce back pain and pressure. It is also helpful to get up and move around every half an hour to an hour.

Medical treatment

Doctors may recommend more advanced options for treating sciatica, such as steroid injections and nerve blocks, but these are considered unsafe options during pregnancy. If sciatica does not go away after your baby is born, you should discuss drug treatment approaches with your doctor.

The Centers for Disease Control and Prevention (CDC) warn against using nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen during pregnancy, as NSAIDs could be linked to an increase in birth defects.

If you find that natural therapies for sciatica pain are not helping and your quality of life is compromised, talk to your doctor about whether acetaminophen or another pain reliever is an option for you during pregnancy.

prevention

It is not always possible to prevent sciatica, especially during pregnancy. Maintaining a healthy weight and not sitting for long periods of time can help.

You can protect your back by exercising and stretching regularly. Also try to avoid heavy and improper lifting during pregnancy.

When to call your doctor

Mild sciatica will go away over time and resolve with birth. However, you should see your doctor if self-help and home remedies do not relieve symptoms, or if the pain gets worse, becomes severe, or lasts for more than a week.

Get medical help right away if you have sudden severe lower back or leg pain accompanied by leg muscle weakness, or if you have problems controlling your bowels or bladder. These could be signs of a condition called cauda equina syndrome, which is a medical emergency and requires surgery.

Summary

Sciatica during pregnancy can be painful and uncomfortable. It is caused by pressure on the sciatic nerve. Stretching can help relieve pain, reduce muscle tension, and improve hip, leg, and back movement. Sciatic pain worsens with prolonged sitting or standing, so it is advisable to change positions and not sit for too long.

A word from Verywell

You should always listen to your body and slow down as sciatic pain and symptoms get worse. Consult your doctor before starting any exercise. If you experience symptoms such as headache, dizziness, and bleeding, get medical help right away.