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Sciatica During Pregnancy: Managing Sciatic Nerve Pain

I admit it. I am lousy at being pregnant. While other first trimester moms are being complimented on their healthy glow, I spend the first trimester of my pregnancy looking puffy, bloated, and blotchy. I may not be able to hold down anything more than animal crackers, but I still somehow manage to put on an extra 75 pounds over the course of 40 weeks (or 42 weeks, in the case of my first pregnancy). My ankles swell into purple Barney-like paws. I can’t take a flight of steps without sitting to rest midway up or down, and I carry my babies so low that I walk bow-legged the last eight weeks before delivery.

As if all this weren’t enough to discourage me from bringing new life into the world, during my first pregnancy, I awoke one morning to find that I was unable to tie my own shoes, sit in a chair, or put on my coat without excruciating pain. I hobbled to my local chiropractor to learn that I was suffering from a rather common condition known as pregnancy-related sciatica or, translated into my vernacular, “major pain in the rear!”

What is Sciatica?

Pregnancy-related sciatica, says Corrie Horshinski, DC, a chiropractor who has been practicing in New York City for 23 years, occurs when a baby’s head presses against the mother’s sciatic nerves, which run down the spine and into the pelvis and upper leg area. It can occur at any point during a normal pregnancy, but it is most common during the second and third trimester, when the baby is larger and in a lower position in the abdomen.

Women with sciatica often experience shooting pains or paralyzing numbness in the lower back or buttocks area and sometimes down the backs of the thighs. The pain can be severe enough to limit a person’s mobility almost entirely, and because it is caused by the position of the baby inside the womb, there’s very little that can be done to relieve the situation entirely until the baby is born.

“As the pregnancy goes on, ligaments and tendons loosen to prepare for the ultimate childbirth, and the back in some women can become quite unstable,” says Horshinski, who recommends regular chiropractic adjustments for sufferers. “Some women get better with a couple of visits, but for those with severe sciatica, I recommend coming in every month or so throughout their pregnancy.”

Eat Right and Exercise

While there is little that can be done to prevent the onset of sciatica during pregnancy, women who exercise regularly and do not overeat before becoming pregnant and during early pregnancy may have an easier time dealing with the discomforts of the condition than their less fit counterparts. This is because people with good muscle tone are better able to support their body structure and may have more control over their range of movement during a sciatica attack.

Although a few women with the most severe and incapacitating forms of sciatica may receive prescriptions for pain medication, Horshinski says she prefers to steer clear of pharmaceuticals whenever possible during pregnancy and instead recommends a combination of soft tissue massage, bed rest, and soothing wet heat alternated with ice pack applications to help calm muscle and nerve spasms.

Helpful Habits

Horshinski also recommends that pregnant women suffering from sciatica pay close attention to their posture, since slumping at a computer for several hours or standing with a baby on one hip can contribute to lower back discomfort.

In addition, pregnant women should always wear flat shoes or shoes with a very low heel, and be careful not to wear shoes that throw their weight backwards, as that may cause additional strain on the lower back and legs.

Many doctors also suggest sleeping on one side on a very firm mattress or even on the floor with pillows rolled up under the knees. When getting out of bed, they suggest, roll onto your side first and let the weight of your feet and legs dangling over the edge of the bed pull your body into an upright sitting position. This puts less stress on your lower back muscles, and you are less likely to trigger a painful muscle spasm than if you had pulled yourself directly into a sitting position.

Exercises to Relax and Relieve Pain

While there is no real cure for sciatica, Horshinski says there are several exercises that may help offer temporary relief to women suffering from sciatica pain, including exercises that stretch the piraformis (the muscle in the buttocks that the sciatica nerve travels through), the hamstring, and calf muscles. Called “Williams Exercises,” these stretches are specifically designed to take pressure off the sciatic muscle and loosen painful spasms. Here are a few examples:

  • On your hands and knees, drop your head and roll your back upwards one vertebrae at a time while tightening your tummy and bottom. Your back should be in a humped position. Then, one vertebrae at a time, drop the spine back into place while bringing your head into a position parallel with your backbone. Repeat this movement several times. When performed a few times a day, this exercise should bring relaxation and relief from lower back pain and tension.
  • Slow squats done ten times a day are great for stretching and toning the upper legs. Be sure to balance yourself by holding onto a countertop or chair.
  • The pelvic tilt not only helps to relieve lower back pain, it also prepares a pregnant woman for giving birth. There are two ways to do this exercise. Standing, for women who are at least four months pregnant, or lying down.
  • Standing: Stand with your spine against a wall and press the small of your back against the wall. Then relax.

    Lying down: Lie with your knees bent and feet flat on the floor. While exhaling, press against the hollow of your back until your spine touches the floor. Then inhale and relax your position. Repeat as many times as you are comfortable.

  • Lie on your back with one knee bent and the opposite ankle resting on the bent knee. Then lift the bent knee off the floor, and slowly stretch the opposite knee away from the resting ankle. Switch legs and repeat. This releases tension in the buttocks muscle.

In addition to these exercises, swimming and walking are excellent ways to relieve pressure on your lower back, bottom, and upper thighs. Just be sure to walk on level ground and avoid inclines.

Of course, exercise in moderation and see your doctor if the pain becomes worse.

For pregnant women in their second and third trimester, prenatal massage from 10 minutes to one hour once or twice a week can help relieve stress on weight-bearing joints and assist in maintaining proper posture, which may improve symptoms of sciatica. Just make sure the massage therapist you choose is certified and registered with your state.

The Silver Lining

While it’s true that many aspects of one’s first pregnancy can be expected to pop up again in subsequent pregnancies, thankfully, pregnancy-related sciatica is instance specific. Since it is caused by the position of the baby at any given time, having sciatica in one pregnancy is not an indication that you will experience it in every pregnancy.

So (knock on wood!), as I enter into the sixth month of my second pregnancy, I write this bloated and blotchy, overweight, puffy, irritable, and winded, but with no signs of the sciatica pain that I experienced in my first pregnancy.

But let’s face it, pain in the rear or not, at the end of the pregnancy rainbow, a sweet little baby is the pot of gold!

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