Sciatica or sciatic-type pain is fairly common during pregnancy. Many women are told this is a normal occurrence during pregnancy (I would use the word common), however we believe women can have happy and healthy bodies throughout pregnancy and I want you to know there is something you can do about it!
The sciatic nerve is made up of several nerves that come off the spinal cord and exit through the low back/sacral bones. They combine into one big, thick nerve that runs through the back of the buttock and branches out again down your leg all the way to your foot. We may experience true sciatica, where the nerve is irritated and causes pain (numbness/tingling/weakness) all the way down the leg. It usually affects only one side and things like sitting (hard chairs, or sitting for extended periods of time), bending forward, hiking or walking uphill or going up stairs can make this feel worse.
It is important to note that sciatica is often confused with Sacroiliac (SI) Joint pain which may give you sciatic-type symptoms. The SI joint is where the end of your spine (sacrum) connects and makes a joint with the back of your pelvic bones. This is held together by ligaments and is undergoing significant changes during pregnancy! If this joint is irritated, it often starts as lower back pain and progresses to radiating pain to the hip and even upper leg (but not usually past the knee). Some will have difficulty riding in a car or standing, sitting or walking too long. Pain can be worse with transitional movements (moving from sit to stand), standing on one leg (putting on pants!) or climbing stairs.
Understanding WHAT you are experiencing is important. There is a difference in how I support women who have sciatica vs. SI joint dysfunction. Understanding WHY you are experiencing sciatic symptoms is also important. If you know the WHY, then you can make more informed choices in how to address it based on the unique needs of your body. Here are some considerations for the why this may occur
Weakness in the core, pelvic floor or hips
Decreased mobility of the hips
Tension in muscles of the hip or pelvic floor
Poor sitting/standing postures
How/where baby is sitting
Hormonal influence
Weight gain/fluid retention
Remember that pain does not equal tissue damage! The pain with either condition can be intense and it is super easy to get worried about it and to reduce or stop activity. KEEP MOVING! It is important to continue moving as you try to work through it, and a little guidance can be really helpful! Here are some general considerations for self-treatment.
Gentle stretches. I want to be VERY clear. If we could all ‘stretch’ our way out of pain, we would have done so already. Stretching and particularly over-stretching can do more harm than help in this case. Gentle stretches where you are tight will give you some temporary relief, however it will be more important to work on strength and posture. Check with your PT first, but self-nerve glides can reduce nerve sensitivity. And range of motion/relaxation work can be more effective than a ‘stretch’
Strength training for your hips, low back and abdominal muscles. This may include working on the specific muscles like the deep core (pelvic floor, TA, diaphragm, multifidus) as well as glut med and max.
Massage or self-trigger point release can also give you some temporary relief, but given how sensitive these tissues can be, please don’t crank on them!
Diaphragmatic breath. Working the diaphragm in coordination with the abdominals and pelvic muscles is a real treat because it nourishes and massages the whole core. It brings you into parasympathetic activity, which is where we rest, heal and ‘downtrain’ our overactive muscles and nerves
Some women really enjoy the relief they get with support belts like this one
Walking. Walk, walk, walk. Even if it is just short distances, several times/day. Motion is lotion. If hills or uneven surfaces are aggravating, stay on level, softer ground if able.
Be mindful of your standing posture
Sleep positioning can be helpful. Getting off those hips or improving your overall alignment can reduce pressure on the back, hips and pelvis
Be mindful of how you bend and lift
Change your sitting posture. No hard chairs! Try sitting on a yoga blanket or towel, just under your sit bones. This will bring your hips just higher than your knees, which will allow you to sit in a more neutral posture for your spine and pelvis. No crossing just one leg over the other! Try to get up/move every 30 min
Be mindful of how you transition. Log roll when moving into/out of bed and move sit to stand with good control. This is a great exercise to strengthen too!
Sciatica and SIJ pain can be a real pain in the ass. BUT, there are lots of resources and support available to you. You do not have to suffer alone and in fact, we believe you can be pregnant and NOT experience unwanted symptoms
All women’s bodies are unique. If you would like to know more about how the above relates to your specific condition, email me here. Please also follow us on Instagram or join our private Facebook Group for a ton of free support on common women’s health concerns.
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