Imagine the surprise a woman must feel while dealing with the physical symptoms and discomforts of pregnancy, to suddenly develop severe back pain. This is not the usual low back pain that is often experienced during pregnancy; it is sciatica. This sharp, shooting pain usually starts in the buttocks and radiates down the back or side of the thigh to the calf and possibly the heel. There may be paralyzing numbness, in addition to the pain, which can be severe enough to limit mobility.
Sciatica can occur at any time in a normal pregnancy but it is most common during the second and third trimester, when the baby is larger and carried lower in the abdomen. Known as Pregnancy-Related Sciatica, it is caused by the pressure of the baby on the sciatic nerve. This is the largest nerve in the body, about the diameter of a finger. Its fibers branch off the spinal cord at the 4th and 5th lumbar vertebra (L4, L5) and the first few segments of the sacrum.
As the pregnancy develops, the abdominal tendons and ligaments become looser to prepare for childbirth. The backs of some women become quite unstable and prone to injury. Medical evaluation should always be sought. In some cases, sciatic pain is due to pressure on the nerve that is caused by damage to the disc between the vertebrae of the spine. This creates inflammation and pain and requires specific treatment.
Most physicians avoid prescribing medications for pregnant patients suffering from sciatica but there are several steps that can be taken to relieve or decrease the discomfort. This includes:
• Massage to reduce muscle tension. Some experts believe that tightness in the gluteus and psosas muscles contribute to sciatic pain. Treatment once or twice a week can help relieve stress on weight-bearing joints.
• Moist heat alternated with ice packs
• Chiropractic treatments may be helpful. Be sure to select a practitioner experienced in treating prenatal patients.
In addition, these helpful habits may decrease the chances of developing sciatica:
• Avoid hours of sitting slumped at a computer or standing with a baby on one hip. Both can contribute to lower back pain.
• Maintain proper posture and try to stand straight.
• Wear flat shoes or ones with a very low heel. Avoid shoes that throw your weight backwards.
• Williams Exercises have been developed specifically for use during pregnancy. They may temporarily relieve sciatica pain as they help strengthen the muscles of the pelvic floor, the back and abdomen.
• Swimming and walking are excellent exercises if not contra-indicated by the physician.
• Avoid walking on an incline as this can cause joint irritation and lead to problems.
• Try to avoid significant weight gain.
• Try sleeping on a firm mattress, lying on one side. A pillow rolled up under the knees may be helpful.
• When getting out of bed, try rolling onto your side first, letting the weight of your feet and legs dangling over the edge of the bed, pull your body into a sitting position. This puts less stress on the lower back, helping you to avoid triggering a painful muscle spasm.
• Bedrest may be necessary at times.
• See your physician if the pain becomes unmanageable.
Sciatica is unique to a pregnancy and may gradually disappear on its own. Just because you had sciatica in one pregnancy does not mean it will appear in a subsequent one.