Sciatica During Pregnancy: Managing Sciatic Nerve Pain

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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.