Sciatic Nerve Pain and Pregnancy
Have you ever been caught off guard by sudden lower back pain? That shooting pain and sudden concurrent spasm are unmistakable. It’s a weird and unexpected event and when it happens it can bring anyone to their knees, but especially expectant moms in that third trimester. Sciatic nerve pain is no joke and can happen to anyone at any time, but pregnant women are especially susceptible. But have no fear, there are methods you can implement to minimize the pain such as physical therapy and acupuncture to name just two.
What is Sciatica?
According to Mayo Clinic, sciatica is a condition that refers to pain that radiates along the path of the sciatic nerve. This nerve branches from your lower back through your hips and butt and down each leg. Usually, sciatica only affects one side of the body.
Sciatica very commonly occurs when a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) compresses part of the nerve. This can cause inflammation, pain, and often slight numbness in the affected leg.
While the pain associated with sciatica can be intense, most cases will resolve with non-surgical treatment in a few weeks. People who have severe sciatica associated with significant leg weakness and bowel or bladder changes may need surgical intervention.
The Prevalence of Sciatica During Pregnancy
Often, women experience an increase in sciatic sensations during pregnancy. Lower back pain and sciatic problems very commonly develop in the third trimester when a woman’s center of gravity shifts, but it can happen at any stage of the pregnancy.
This is due to the fact that the growing baby and expanding uterus put pressure on the sciatic nerve, causing inflammation, irritation, and pain. Sciatica is a very distinct feeling of shooting pains that start in the lower back and radiate down the legs.
Very often, sciatica is caused by a herniated or bulging disc, but in pregnancy, that's a rare cause, affecting only about 1 percent of pregnant women. Causes of sciatic nerve pain in pregnancy often include the hormone relaxin, which a woman’s body produces to loosen ligaments in preparation for childbirth.
Symptoms of Sciatica
Sciatic nerve pain is unmistakable, as it radiates from the lower spine, to the bottom, and down the back of the leg. You can feel the discomfort almost anywhere along the nerve pathway, but it's especially likely to follow that path from your lower back to your butt and down the back of your thigh and calf.
The pain can vary from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can even feel like an electric shock. Coughing, sneezing and sitting for extended amounts of time can intensify the pain and aggravate symptoms. Usually, the pain only affects one side of the body. Numbness, tingling, or muscle weakness in the foot or back of the leg can also occur, and sometimes in combination with one another.
When to See a Doctor
Mild sciatica often goes away over time. If the pain is unbearable, lasts longer than a week, or gets progressively worse, a doctor should be consulted.
Get immediate medical attention if:
- Sudden, severe pain in the lower back or leg and numbness or muscle weakness in the leg occurs
- The pain follows a traumatic injury
- There is trouble controlling your bowels or bladder
Causes of Sciatica
Sciatica occurs when the sciatic nerve gets pinched, often the result of a herniated disk in the spine or by an overgrowth of bone in the vertebrae. On rare occasions, the nerve can be compressed by a tumor or damaged by diabetes.
Risk factors of sciatica:
Age-related changes in the spine, i.e. herniated disks and bone spurs, are the most common causes of sciatica.
Excess body weight can contribute to spinal changes that trigger sciatica by increasing stress on the spine.
Any job that requires a lot of twisting of the back, heavy lifting, or driving a car or truck for extended periods of time can contribute to sciatica.
People who don’t move much or sit at a desk all day are more likely to develop sciatica than people who are active.
Diabetes affects the way the body uses blood sugar which can increase the risk of nerve damage.
Most often, those who suffer from sciatica fully recover even without treatment. However, it is possible for sciatica to cause permanent nerve damage. If someone develops any of the following symptoms, they should seek medical attention immediately:
- Loss of feeling in the leg
- Weakness in the leg
- Loss of bowel or bladder function
Sciatica is not always preventable, and it frequently recurs, but there are some things that can be done to protect your back:
To keep the back strong, it’s imperative that the core muscles are strong.
Practise good posture while sitting.
There are a few things to consider when sitting:
- Choose a place to sit with good lower back support, armrests and a swivel base
- place a pillow in the small of your back to maintain its normal curve
- keep your knees and hips level
Use good body mechanics.
While standing for long periods of time, rest one foot on a stool from time to time. When lifting something heavy, lift with your legs. Keep your back straight and bend only at the knees. Hold the object close to your body. Avoid lifting and twisting at the same time. Find someone to help you if the object is heavy or awkward.
If your sciatica doesn't get better with the use of at-home, self-care measures like the use of a heating pad and pregnancy pillow, some of the following over-the-counter and prescription treatments can be recommended by your doctor.
- Muscle relaxants
- Tricyclic antidepressants
- Anti-seizure medications
Once the acute pain starts to relent, a physical therapist or healthcare professional can create a rehabilitation program to help prevent future episodes of sciatica. This usually includes exercises to fix your posture, strengthen the muscles supporting the back, and improve flexibility.
In some cases, your doctor might recommend an injection of a corticosteroid medication into the area around the involved nerve root to help reduce pain by suppressing inflammation around the irritated nerve. The effects can last up to a few months.
Surgery is usually the last resort when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when pain gets progressively worse or doesn't improve with other less invasive treatments. Surgery can remove the bone spur or the part of the herniated disk that’s pressing on the pinched nerve.
For more information on keeping healthy during your pregnancy, see our Medical Concerns During Pregnancy directory