What Is Sciatica?
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 to the toes. Although the nerve is in both legs, when you get sciatic pain, it usually only affects one side, often radiating from the hip downward. However, some pregnant women do experience sciatic pain on both sides. The pain can be sharp, tingling, or burning, or it may just be a persistent ache. Some describe the feeling as stabbing, prickly, or like a bolt of pain. You might also have some muscle weakness or numbness. Sciatica pain can happen continuously or periodically come and go with varying intensity. Usually, the intensity and frequency of the symptoms grow as the baby does.
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 (including weight gained during pregnancy) and prolonged sitting can also increase risk of developing sciatic pain. During pregnancy, weight gain and fluid retention can exacerbate sciatica, as can the increased size of your uterus. Your altered center of gravity can also be a factor. Especially during the third trimester, as your baby starts dropping and getting into the position needed for birth, your baby’s head might land on the sciatic nerve, causing classic sciatica symptoms. Another contributing factor is the hormone relaxin, which is produced in higher amounts during pregnancy. This hormone helps get the pelvis ready for childbirth by relaxing your ligaments. But as ligaments become looser, the sciatic nerve can shift and become pinched.
Diagnosis
If you’re experiencing any possible sciatica symptoms, call your obstetrician. Your doctor may want to examine you or suggest you consult your general practitioner or a physical therapist. Typical symptoms of sciatica include a loss of feeling or muscle weakness on the affected side and shooting pain in the hips, buttocks, or legs. A less common but very concerning symptom is loss of bowel or bladder function. If you experience a sudden loss of control of your bladder or bowel you need to seek immediate medical attention. Note that while sciatica might initially feel better with rest, the symptoms tend to worsen over time with inactivity.
If It’s Not Sciatica, It Could Be Sacroiliac Joint Pain
Your doctor will want to rule out sacroiliac (SI) joint pain, which is also common in pregnancy. This discomfort is characterized by pain in the SI joint region, the pelvic area where the sacrum (the triangular-shaped bone at the bottom of the spine) connects to the right and left iliac bones. The iliac bones are the large, wing-like bones that form the upper portion of the pelvis. Pregnant women often experience pain in the SI joint because of the natural loosening of the pelvic ligaments and tendons (caused by the hormone relaxin) to prepare the body for childbirth. This relaxing of the ligaments and tendons creates more pelvic movement and less stability, which is ideal for delivery but can also result in a deep, radiating ache in the pelvic region. SI joint pain tends to occur in the buttock, hip, groin, and back of the thigh but does not extend below the knee. In contrast, sciatica discomfort often radiates all the way down to the toes. Exercises that promote core and lumbar stability can help to reduce SI joint pain (as well as sciatica pain) during pregnancy, which usually resolves after the postpartum period. Your doctor may do a physical exam that will help discern whether the discomfort you feel is due to sciatica, SI joint pain, or another issue. Additionally, they can provide suggestions for finding relief.
Coping Tips
Although sciatica can occur at any time, it is most likely to present in the second or third trimesters of your pregnancy as you (and your baby) gain more weight and your baby shifts to get into position for birth. The good news is that sciatica does tend to respond to home remedies. Typically, sciatica goes away on its own, although it can take some time—and may take the birth of your baby to fully resolve. 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 recommended the “better” side for pregnant women due to enhanced blood flow, but if sleeping on your right relieves your symptoms, it’s OK to choose that side). Take warm (but not hot) showers. Use a warm (not hot) heating pad on the affected area. Use a pillow (a regular one or a specially designed pregnancy pillow) for more comfort while sleeping. Place the pillow between your legs and under your belly to better align the pelvis and reduce pressure on the sciatic nerve. Consider getting a prenatal massage, trying acupuncture, getting chiropractic care to help relieve pain. Check with your obstetrician before doing either of these, just to make sure it’s OK. Swimming can help relieve some pain because of the buoyant properties of the water, which can reduce pressure on the sciatic nerve. Stretching and yoga can also reduce discomfort. Avoid standing or sitting in the same position for long periods of time. Avoid heavy lifting. Manage your weight gain appropriately and try to gain weight gradually rather than in bursts to minimize any sudden pressure on your nerves and bones. Seek advice from your obstetrician if you’re having difficulty with this.
A Word From Verywell
Most of the time, having your baby eliminates pregnancy-related sciatica, although it may persist even after you’ve given birth. In those cases, it will usually resolve as excess fluid and weight gained in pregnancy is lost, which will alleviate pressure and compression on the sciatic nerve. If you’re experiencing sciatica, make sure to talk about any remaining symptoms during your postpartum visits. Your doctor will refer you to the care of a specialist if needed.
