3. Sciatica of Pregnancy
"For stubborn sciatic pain during pregnancy that doesn’t respond to home remedies, massage and chiropractic adjustments are great for a reset. Loosening tension in the soft tissues of the lower back and hips to restore restricted motion to the surrounding joints takes pressure off of the nerve and often improves or completely resolves sciatic symptoms."
Sciatica is truly a pain in the bum. Technically it is nerve pain caused by irritation to the sciatic nerve. It’s also the number one pregnancy ailment that my fellow practitioners and I see in our primarily pre and postnatal wellness center and thankfully, the pregnancy version responds really well to conservative chiropractic care.
Since the sciatic nerve, which is the longest nerve in the body, carries both motor and sensory information, irritation can cause sensory symptoms, such as pain, numbness and tingling, and motor symptoms like weakness of muscles or the feeling your leg might buckle under you when you are on your feet. ‘Classic’ sciatica is compression of the sciatic nerve roots in the lower back and typically radiates down the leg to the knee or lower. ‘Sciatica of Pregnancy’ is a term that I created to describe compression of the outer bundle of the sciatic nerve in the gluteal muscle causing pain generally localized to the upper outer glutes.
As a baby grows, and the uterus along with it, the center of gravity in the pregnant body shifts forward creating strain on the lower back and pelvis. That coupled with extra weight on the hips while side sleeping creates stiffness and tension in the muscles and tendons that run right across the sciatic nerve in the gluteal region. This can be especially irritating for people who normally sleep on their front or back and now are subjected to pressure on their hips all night. Additionally, in some positions the weight of the baby and their ‘luggage’ can push down on the sciatic nerve, causing further compression.
Check out this related episode of The Informed Pregnancy Podcast: https://bit.ly/3JKFgYo
Good news: this type of sciatica responds extremely well to conservative treatments. At home, a warm shower or a heating pad may relieve muscle tension and gentle stretching can help as well. Although it’s tempting to curl up and stay still when in pain, gentle exercise such as swimming, walking, and pregnancy yoga tend to help with both prevention and treatment. Talk to your doctor or midwife about alternating sides when sleeping, using a small pillow between your knees and potentially using a semi reclined position with an adjustable bed or supportive pillows to give your hips a rest.
In addition to adjusted sleep positions, I often recommend a piriformis stretch. To do this, stand facing a bed or chair that comes to hip level. Hold on for balance as you raise one leg so that it is folded in front of you resting on the bed as if you were going to cross your legs. You may feel a stretch in this position or you may need to lean forward, keeping your abdomen as straight as possible. Hold this position for about 30 seconds to one minute depending on comfort level then repeat with the other side.
When Home Remedies Don’t Work
For stubborn sciatic pain during pregnancy that doesn’t respond to home remedies, massage and chiropractic adjustments are great for a reset. Loosening tension in the soft tissues of the lower back and hips to restore restricted motion to the surrounding joints takes pressure off of the nerve and often improves or completely resolves sciatic symptoms. In our office we use medium to deep tissue massage, trigger point therapy and chiropractic adjustments.
If you have pain that does not respond to any of these techniques, if no position is comfortable for you, if the pain is on both sides at the same time or if it wakes you up at night repeatedly, it may be something more serious and you should see a medical doctor for an evaluation. Luckily, most of the time sciatic pain during pregnancy is relatively easy to address leaving you more comfortable and functional in both mind and body.
To schedule an appointment with Dr. Berlin, please visit Berlin Wellness Group at: www.doctorberlin.com
Dr. Berlin is an award winning prenatal chiropractor, childbirth educator, and labor support doula as well as the host of the Informed Pregnancy Podcast where each week, parents, birth professionals, and parenting experts weigh in on a full range of topics surrounding the perinatal period. Dr. Berlin runs a successful perinatal wellness group in Los Angeles, CA with his wife Dr. Alyssa Berlin with whom he shares four kids, two guinea pigs, and one dangerously smart Aussiedoodle.