Sciatica During Pregnancy

It’s a pain in the behind — literally. Find out what causes sciatica during pregnancy and what you can do to get some relief.

You knew pregnancy was going to mean a lot of firsts — like feeling the incredible first flutter of baby moving in your belly. But back pain that just won’t go away? That might not have been quite the experience you had in mind when you first envisioned yourself with that proverbial pregnancy glow. While a majority of mothers-to-be experience some dull, throbbing aches in the middle of the back or the butt, a small percentage grapple with the searing pain of sciatica during pregnancy — a painful but fortunately temporary condition.

WHAT IS SCIATICA?

The sciatic nerve, the largest in the body, starts in the lower back, runs down the buttocks and branches down the back of the legs to the ankles and feet. In most cases sciatica — sharp, shooting pain, tingling or numbness that starts in the back or buttocks and radiates all the way down the backs of your legs – happens when this nerve gets compressed by bulging, slipped or ruptured discs, arthritis, or by a narrowing of the spinal cord (also called spinal stenosis). But rarely, women experience sciatica as a short-term side effect of pregnancy.

WHAT CAUSES IT DURING PREGNANCY?

Contrary to popular belief, sciatica is not usually caused by pregnancy. But if you're one of the few who do experience this pain while pregnant, you can blame it on the usual suspects:

Weight gain and increased fluid retention can put pressure on the sciatic nerve where it passes through the pelvis, compressing it (ouch!).

Your expanding uterus might also press down on the sciatic nerve in the lower part of your spine.

Your growing belly and breasts shift your center of gravity forward and stretch your lordotic curve (the dip just above your butt). This can cause the muscles in your butt and pelvic area to tighten up and pinch the sciatic nerve.

Another possibility? When the baby starts to shift into the proper birth position in the third trimester, his head can rest directly on the nerve, causing a major pain in the butt (and back and legs).

WHAT YOU NEED TO KNOW

Sciatica will most likely occur during the third trimester, when both you and your baby are bulking up (it can develop earlier, but it's not common). Most women typically experience pain just on one side, though you may feel it in both legs. Sciatica can be constant or intermittent, depending on the amount of pressure placed on the nerve — so pain may increase as you put on more weight and retain more fluid. And it can stick around for a few months or so after you’ve given birth, until you’ve shed the excess weight and fluid pressing on the nerve.

WHAT YOU CAN DO TO RELIEVE SCIATICA

Use a warm compress on the spot where you feel the pain.

When you can, take a break — getting off your feet and resting in a comfortable position can ease some leg and lower back pain.

Sleep on the side of your body that’s pain-free. For example, if you feel pain on your left side, lie down on your right side.

For extra comfort at night, use a firm mattress with plenty of back support, and place a pregnancy pillow or a regular pillow between your legs to help keep the pelvis in better alignment and take some pressure off the sciatic nerve.

Do some pelvic tilts with your Kegels — they’ll help strengthen your core muscles and can help reduce inflammation.

Swimming can also take off some of the pressure, since the buoyancy of the water temporarily relieves the spine of the pregnancy weight.

Acupuncture, chiropractic adjustments or therapeutic prenatal massage (always with a trained and licensed practitioner), can sometimes help. A customized physical therapy regimen could also offer some relief.

Try to gain weight slowly — a major jump in pounds could put undue pressure on the sciatic nerve. Women who were a normal BMI before getting pregnant should aim to gain only up to two pounds in the first trimester, about 8 more pounds in the second trimester and a maximum of 20 more pounds in the third trimester, for 30 pounds total weight gain in pregnancy.

If the pain is severe, talk to your doctor, who may recommend acetaminophen in a dosage that will take the edge off the pain but keep you and baby safe.