Pain is a part of life, and it’s never more true than during pregnancy. Carrying your little bundle of joy in your womb for nine months is as wonderful an experience as motherhood is, but no woman who has experienced pregnancy can deny that pain is an integral part of this experience too. 

From sore and tender breasts and round ligament pain to contractions during pregnancy and labour pain - pregnant women endure a lot of discomfort with a lot of grit during their gestation period. Back pain might seem like just one of the types of pain pregnant women experience. In fact, according to a study published in Anesthesia Essays and Researches in 2019, about 25-90% of women experience pregnancy-related lower back pain that starts anytime between the 20th week of pregnancy and the 28th week of pregnancy.

But when it’s caused by the compression of the sciatic nerve, the back pain pregnant women experience can get unbearable. The sciatic nerve is the largest nerve in the human body and is formed by the union of five nerve roots originating in the lower spine. This nerve connects the spinal cord with the skin and muscles of the thigh, leg and feet, and runs right through the buttocks from under the uterus.

Read more: Avoid these habits to ensure a safe and healthy pregnancy

It is, therefore, in the prime location to get compressed as your uterus grows during pregnancy. The worst part is that your uterus will keep growing throughout the pregnancy to accommodate the growing baby, which means that the compression on the sciatic nerve will also keep increasing. The good news is that you might get relief from this pain soon after your baby is born and your uterus goes back to its normal size. During pregnancy, however, you can do a number of things to manage this sciatica pain.

  1. What causes sciatic pain during pregnancy?
  2. Are lower back pain and sciatic pain during pregnancy the same?
  3. Symptoms of sciatic pain during pregnancy
  4. Tips to avoid sciatic pain during pregnancy
  5. Home remedies for sciatic pain during pregnancy
  6. When to contact the doctor about pain during pregnancy
Doctors for Sciatic pain during pregnancy

The sciatic nerve is the largest nerve in the human body, and it runs under the uterus and all the way down the buttocks and legs to the feet. The most common causes of sciatic nerve pain are a herniated disc, bone spur on the spine or narrowing of the spine - all of which can compress the nerve. 

While these are the common causes behind sciatic nerve pain, the reasons behind the same pain during pregnancy are quite different. You might assume that the growing weight of the baby directly causes sciatic nerve pain, but it doesn’t. A more viable explanation is that pregnancy hormones loosen and stretch the ligaments in the lower abdominal region as the uterus grows to accommodate the baby. The function of these ligaments is to support and stabilise the spinal cord, but once they stretch out, this support is destabilized.  

This in turn leads to the pinching or compression of the sciatic nerve and sciatic nerve pain. The baby’s weight and position is an added pressure on this already pinched nerve, making the pain more intense.

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Lower back pain is one of the most common symptoms of pregnancy, and can occur due to a number of reasons, including weight gain, lack of balance and improper posture due to growing belly, varicose veins, etc. Sciatic nerve pain is actually one of the rare clinical entities of lower back pain, and is specifically caused by the pinching or compression of the sciatic nerve. Similarly, varicose veins can also cause pain in the lower back and legs, but the cause is the compression of the inferior vena cava.

How to tell if the pain you’re experiencing is related to the sciatic nerve and not any other cause? The easiest ways to tell are to check for varicose veins on your legs, vulva and rectum, and to monitor the pain to see if it radiates from the spine towards the legs. The best thing to do is to consult your obstetrician and get diagnosed properly.

Since back pain is a common complaint during pregnancy, many pregnant women often fail to realise that they’re suffering from sciatic nerve pain. This is the reason why knowing precisely why and how sciatic pain occurs during pregnancy is very important. Sciatic nerve pain is often defined as a shooting and burning pain radiating from the hip to the feet, and usually happens at only one side at a time. The following are its key symptoms.

  • Occasional or constant shooting pain on either side of your buttocks or a leg.
  • The pain radiates from the back side of your buttocks and can be experienced on the back of the thigh all the way down to the foot - basically along the sciatic nerve. 
  • The pain can be described as sharp, shooting or burning.
  • The affected leg and foot might also have numbness, tingling, pins and needles and weakness.
  • Difficulty in walking, standing or sitting.
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There are a number of things you can do during your pregnancy to avoid sciatic pain. Remembering to ease your movements and not engage in activities that are too strenuous is very important. Try the following tips:

  • When picking something from the floor, make sure you bend both your knees and keep your back straight.
  • Avoid lifting heavy objects.
  • Avoid turning around with just your waist and hip. Move your feet while turning to avoid twisting your spine.
  • Avoid wearing heels, and opt for flat shoes to evenly distribute your weight on both legs and feet.
  • Avoid carrying a bag on one side during pregnancy because this will not distribute your weight evenly. If you’re carrying shopping bags, distribute the products equally and carry the same weight on both sides to maintain balance.
  • Keep your back straight and support it properly with a wall, chair or pillows while at work, home or travelling. Get a maternity support pillow if you can.
  • Increase your rest time as your pregnancy progresses.
  • Use a firm mattress to sleep on. If your mattress is too soft, you can use a hardboard underneath to make it more firm.

The simple fact is that if you’re suffering from sciatic pain during pregnancy, it will not go away completely until you deliver your baby and every function of your body goes back to its pre-pregnancy state. The best you can do during your pregnancy is to use the above mentioned tips to not aggravate the pain and use the tips mentioned below to manage the pain with ease at home. 

You could also ask your doctor for medications to manage the pain, but a lot of people prefer not to take painkillers during pregnancy for fear of complications. Instead, the simple home remedies mentioned below are easier to follow and completely safe.

Hot compress

Applying heat to an inflamed area, especially if the inflammation is due to nerve compression, is a good way to reduce pain. Hot water bags, electric heat pads, etc should be applied to the areas of the back where the roots of the sciatic nerve are located, as well as down the course of the entire nerve.

This will improve the blood flow to the aching muscles of the back and legs and relieve sciatic pain. However, make sure you do not apply heat for more than 15-20 minutes once every three-four hours.

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Exercise

A gentle but effective exercise routine can keep your body fit and pain at bay at the same time. Your exercise routine should start with a simple stretching for your hips, back, shoulders, arms and legs. Make sure you avoid forward bends, crunches or anything that can constrict or strain your abdomen unnecessarily.

Walking at a good pace for 15-20 minutes every day should also improve circulation in your hips and legs as well. Walking is in fact one of the best exercises for sciatic nerve pain during pregnancy.

Yoga

A lot of women in urban centres now tend to join prenatal yoga classes, where trimester-appropriate yoga and meditation is taught to pregnant women to ease all symptoms of pregnancy, including sciatic nerve pain. However, with such yoga lessons now available online, you can try yoga at home to relieve both stress and sciatic pain without having to step out at all.

Yoga, being a more holistic approach to  exercise, can improve your pain management skills and keep you mentally fit and happy as well.

Maintain posture

With your baby and baby bump growing, your centre of gravity is going to shift. This will not only make you feel out of balance, but also likely increase your sciatic pain. It’s therefore best to maintain a good posture throughout your pregnancy to keep this pain at bay and to feel more balanced. To do this, you need to remind yourself of the following:

  • Sit and stand with your spine straight and keep your neck the same way as well.
  • Hold your chest high without jutting your breasts outward.
  • Keep your shoulders level and relaxed.
  • Make sure you don’t slouch.
  • Don’t lock your knees while sitting.
  • Maintain a wide stance while standing to give your body ample support.
  • Choose ergonomically designed chairs which support your back to sit on, and support your back further with an appropriate pillow.

Maternity belt

Just like a perfectly fitted maternity bra can help ease the soreness and pain in your ready-to-lactate breasts during pregnancy, maternity belts are supposed to help you deal with back pain. Also known as belly bands, maternity belts are flexible support garments that grow as your baby grows.

Especially designed for women in their second and third trimesters, maternity belts support the back and abdomen, correct posture and ensure that any pain originating in these areas are at a minimum. Apart from working wonders towards easing sciatic pain, these belts also relieve round ligament pain, and provide ample support immediately after delivery.

Prenatal massage

Prenatal massage therapy has an ambivalent history with the medical community, with most experts believing it to be extremely harmful during the first trimester. However, research in recent years has shown that prenatal massage therapy in the second and third trimesters can help pregnant women cope with most types of pain, including joint pain, neck pain, back pain and sciatic pain.

Still, you should consult your doctor before going in for a prenatal massage therapy and make sure you only go to a licensed and experienced practitioner.

While mild to moderate sciatic pain is not much to worry about, if the pain gets too intense or frequent, it can indeed be a cause for worry. You should contact your doctor and emergency health services immediately:

  • If you’re in your second or third trimester, this could be a sign of premature labour.
  • If you also have a fever, vaginal bleeding or experience pain while urinating.
  • If you have or are losing feeling in either or both legs, buttocks and genitals.
  • If you have pain under your ribs on one or both sides.
Dr Sujata Sinha

Dr Sujata Sinha

Obstetrics & Gynaecology
30 Years of Experience

Dr. Pratik Shikare

Dr. Pratik Shikare

Obstetrics & Gynaecology
5 Years of Experience

Dr. Payal Bajaj

Dr. Payal Bajaj

Obstetrics & Gynaecology
20 Years of Experience

Dr Amita

Dr Amita

Obstetrics & Gynaecology
3 Years of Experience

References

  1. Saxena, AK. et al. Pregnancy-induced Low Back Pain in Indian Women: Prevalence, Risk Factors, and Correlation with Serum Calcium Levels. Anesth Essays Res. 2019 Apr-Jun; 13(2): 395–402. PMID: 31198266
  2. Cleveland Clinic. [Internet]. Cleveland. Ohio; How to Handle Sciatica During Your Pregnancy
  3. American Pregnancy Association [Internet]. Irving, Texas, USA; Pregnancy and Sciatic Nerve Pain
  4. Katonis, P. et al. Pregnancy-related low back pain. Hippokratia. 2011 Jul-Sep; 15(3): 205–210. PMID: 22435016
  5. Shah, Shalini. et al. Pain Management in Pregnancy: Multimodal Approaches. Pain Res Treat. 2015; 2015: 987483. PMID: 26448875
  6. American College of Obstetricians and Gynecologists. [internet], Bethesda (MD), USA; Physical Activity and Exercise During Pregnancy and the Postpartum Period
  7. National Health Service [Internet]. Hertfordshire. UK; Back pain in pregnancy
  8. Cleveland Clinic. [Internet]. Cleveland. Ohio; Sciatica
  9. Field, T. et al. Pregnant Women Benefit From Massage Therapy. J Psychosom Obstet Gynaecol . 1999 Mar;20(1):31-8. PMID: 10212885
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