How to treat sciatica during pregnancy

What is sciatica?

Sciatica is pain that results from the irritation, inflammation, or compression of the sciatic nerve, which runs from your lower spine to your butt and down the back of your legs.  

The pain can be mild or severe, and deep and dull or shooting and sharp. Sciatic nerve pain in pregnancy is most common during the third trimester, as you and your baby get larger, although it can happen earlier in pregnancy.

Sciatic nerve pain can come and go or be constant. It usually only happens on one side, though it can affect both sides. It may worsen as pregnancy progresses, and it may even continue for a short while postpartum.

What are the symptoms of sciatica?

Symptoms of sciatica can include:

• Pain in the lower back, butt, and/or legs
• Difficulty walking or standing
• Tingling or weakness in the legs or feet
• Tenderness in the lower back

Talk to your doctor if you have any symptoms of sciatica.

Note: If you have a loss of sensation in the legs, feet, groin, bladder, or anus (which may cause incontinence or make it difficult to urinate or have a bowel movement), talk with your doctor immediately. These are possible signs of a severe disk herniation. Although this is unlikely to happen, it's considered a serious medical emergency and may require immediate surgical correction.

Causes of sciatica during pregnancy

Sciatica is usually caused by a herniated or bulging disc, but in pregnancy, that's a rare cause, affecting only about 1 percent of pregnant women.

Causes of sciatic nerve pain in pregnancy may include:

• Relaxin: Your body produces this hormone to loosen ligaments in preparation for childbirth. As the ligaments stretch, joints can become unstable and muscles can become tense, which can contribute to sciatic pain.
• A shifting center of gravity: Your body's center of gravity shifts forward during pregnancy, which can cause the muscles in your pelvis and butt to tighten and pinch the sciatic nerve.
• Weight: The weight of your growing baby and your expanding uterus may press down on the sciatic nerve.
• Your baby's position. As they settle into birth position in the third trimester, your baby's head may rest on your sciatic nerve.

What can you do to relieve sciatica pain?

Most women find their sciatic pain goes away within a few months of giving birth. In the meantime, you may find relief by trying these methods:

• Take warm showers and use warm compresses or a heating pad (for 10 minutes at a time).
• Gently stretch the muscles with stretching exercises or prenatal yoga.
• Rest. Don't sit in one position for long periods, though.
• Sleep on the opposite side of the pain (if the pain is on one side).
• Use plenty of back support when you're sleeping. Sleep on a firm mattress, and use a pregnancy pillow for support. Placing a pillow between your legs may take the pressure off the sciatic nerve.
• Try Kegel exercises and pelvic tilts to help strengthen muscles
• Swim for exercise. Because of the buoyancy, swimming takes the pressure off the nerve.
• Try alternative therapies, such as acupuncture, chiropractic treatment, and massage therapy. Be sure to find practitioners who have experience treating pregnant women.
• Ask your provider which pain medication would be most effective and safest for you and in what doses.
• Ask your provider for a referral for physical therapy to build strength and good posture.

Lower back pain during pregnancy is very common, but it's important to talk to a doctor about your symptoms – especially if they don't go away after birth – to rule out any underlying problems.

Learn more:

How to get comfortable in bed when you're pregnant

Lightning crotch: Jolts to the pelvis during pregnancy

Round ligament pain

Pregnancy symptoms you should never ignore