An Overview of Sciatica During Pregnancy

Causes, Diagnosis, and Coping Tips

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You don’t have to be pregnant to experience sciatica, but when you are pregnant, sciatica is unwelcome discomfort—a literal pain in the butt! Fortunately, there are things you can do to relieve the pain or discomfort of sciatica during pregnancy.

When people talk about sciatica, they’re referring to pain that is felt along the sciatic nerve. This nerve travels from the lower back, past the hips and buttocks, and down each leg. Although the nerve is in both legs, when you get sciatic pain, it usually only affects one side.

The pain can be sharp or burning, or it may just be a persistent ache. You might also have some muscle weakness or numbness.

Causes During Pregnancy

Sciatica usually occurs when the sciatic nerve is pinched by a herniated disk or a vertebral bone spur. Obesity or weight gain can increase stress on the spine, increasing risk, and prolonged sitting can also increase risk.

During pregnancy, weight gain and fluid retention can cause sciatica, as can the increased size of your uterus and your altered center of gravity. Especially during the third trimester, as your baby starts dropping and getting into the position needed for birth, their head might land on the sciatic nerve, causing classic sciatica symptoms.

In addition, the hormone relaxin is produced in higher amounts during pregnancy. It helps get the pelvis ready for childbirth by relaxing your ligaments. As ligaments become looser, the sciatic nerve can shift and become pinched.

Diagnosis

If you’re experiencing sciatica symptoms, call your obstetrician. She might want to examine you, or she might suggest you go to your general practitioner.

A general practitioner may do a physical exam that will help discern whether the discomfort you feel is due to sciatica.

Coping Tips

Although sciatica can occur at any time, it is most likely to occur later on in your pregnancy as you gain more weight and as your baby gets into position for birth.

Talk with your obstetrician about any sciatica pain, especially if you experience any loss of feeling or muscle weakness on the affected side, or if you lose bowel or bladder function. Note that it might initially feel better to rest and be inactive, but sciatica tends to get worse with inactivity.

The good news is that sciatica does tend to respond to home remedies and typically goes away on its own, although it can take some time. Here are some steps you can take to actively manage sciatica or sciatic pain during pregnancy:

  • Sleep on the side of your body that is not affected, even if it’s your right side (the left is often the “better” side for pregnant women)
  • Take warm (but not hot) showers
  • Use a warm (not hot) heating pad on the affected area
  • Use a pregnancy pillow for more comfort while sleeping, and place a pillow between your legs to better align the pelvis and reduce any pressure on the sciatic nerve
  • Consider getting a prenatal massage or acupuncture to help relieve pain; check with your obstetrician before doing either of these, just to make sure it’s okay
  • Swimming can help relieve some pain because of the buoyant properties of the water, which helps take pressure off of the nerve
  • Manage your weight gain appropriately and try to gain weight slowly to minimize any sudden pressure on your nerves and bones; talk with your obstetrician if you’re having difficulty with this

If the pain is severe, ask your obstetrician if there is any medication that might be safe for you to take during pregnancy.

When it’s related to pregnancy, sciatica may last even after you’ve given birth, until some of your pregnancy weight gain is lost and the sciatic nerve is no longer compressed by any weight or excess fluids. If you've experienced sciatica, make sure to talk about any remaining symptoms during your post-partum care. Your doctor will flag if you need to seek specialist care.

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