Sciatica During Pregnancy: Here’s What to Know

Pregnant women may enjoy many of the aspects of carrying a child. But sciatica during pregnancy is likely not an experience anyone remembers fondly.

Here, learn everything you need to know about sciatica during pregnancy, including causes, risk factors, treatment options, and more.

What Is Sciatica During Pregnancy?

The sciatic nerve is the longest, thickest nerve in your body. Sciatica is characterized by pain that follows the nerve’s path. The pain may span the bottom half of your body, from your pelvis and down to your toes.

Sometimes what seems like sciatica during pregnancy may actually be pain in the area of the sacroiliac (SI) joint — the joint where the sacrum, the triangular bone in the lower part of the spine, connects to the iliac bones, which are the large, winglike bones that form the upper portion of the pelvis.

Causes of Sciatica During Pregnancy

Changing hormone levels, along with mechanics — weight gain, shifting center of gravity, and stretched core muscles — can contribute to the development of sciatica during pregnancy.

Women can get mechanical irritation of the sciatic nerve from the change in body shape and size during pregnancy, according to Ai Mukai, MD, a physical medicine and rehabilitation physician in Austin, Texas. “Pregnancy hormones loosen the joints in preparation of birth, and this can cause a lot of shifting and stretching of the ligaments and joints of the pelvis, leading to sciatica,” she says.

Furthermore, the weight of the developing fetus puts pressure on the sciatic nerve, which runs under the uterus, down to the legs. That’s why pregnant women can feel sciatic pain in that area of the body.

“The symptoms are usually worse after the greatest weight gain, which typically occurs in the third trimester,” says Atul Patel, MD, a physical medicine and rehabilitation physician at the Kansas City Bone & Joint Clinic in Kansas.

The aforementioned factors associated with sciatica in pregnancy can affect any pregnant person. Additionally, the following risk factors may further predispose a person to developing sciatica:

• History of pelvic trauma
• Chronic lower back pain
• Lower back pain during a previous pregnancy

Treating Sciatica in Pregnant Women

In the event sciatica does occur during pregnancy, physicians and patients typically want to be conservative with treatments — avoiding medication and unnecessary procedures, if possible.

A few strategies for naturally relieving sciatica during pregnancy include the following:

• Getting ample rest
• Lying down on the side of your body opposite the pain to help alleviate some of the pressure on the nerve
• Avoiding heavy lifting
• Not standing for long periods
• Doing low-impact exercises, such as swimming
• Applying hot or cold compresses to painful areas
• Considering acupuncture
• Wearing a maternity support belt
• Booking a few sessions with a physical therapist to learn proper positioning techniques and how to transfer in and out of bed and in and out of chairs and vehicles, Dr. Patel suggests

More involved treatments aren’t off the table, especially for those who need them.

“If the pain is severe or she has neurologic findings (sensory changes or weakness), we can still perform a spinal injection to relieve pain, using ultrasound rather than X-ray guidance,” says David A. Spinner, DO, a physiatrist and director of pain management at White Plains Hospital in New York, who specializes in treating pregnant women who have sciatica.

However, Dr. Mukai says her first line of treatment is typically therapy-based. “I usually get patients into pelvic therapy with a certified pelvic therapist to work on looking at the pelvic floor function and teach techniques to try to self-correct alignment issues,” she says. “I also recommend a pregnancy support belt or an SI joint belt to help support the pelvis.”

According to the American Pregnancy Association, always contact your healthcare provider if the pain becomes constant, gets more frequent, or becomes more severe.

The Takeaway

• Sciatica is nerve pain related to the sciatic nerve, which is the longest and thickest nerve in the body. The pain may run from below the pelvis to the toes. It can occur during pregnancy.
• Pregnant women are predisposed to experience low back pain, which may sometimes be sciatica. Shifting hormones and body shape may contribute to low back pain during pregnancy.
• A variety of lifestyle strategies and noninvasive treatments may help ease back pain during pregnancy, including stretching, resting, and applying hot or cold compresses. For persistent or worsening pain, always see your healthcare provider.