Sciatica in pregnancy

What is sciatica?

The sciatic nerve is the largest nerve in the human body. It runs down your lower back and through the back of the leg, right down to your toes. 

The most important thing to know about sciatica is that it is not a diagnosis. Sciatica is the term used to describe the symptoms of radiating pain down the lower back, hips and legs, which can be the result of different underlying causes, including pregnancy. 

What are the symptoms of sciatica in pregnancy?

You can experience sciatica at any point during your pregnancy, but it is more common in the third trimester. 

Sciatica is when your sciatic nerve becomes irritated, causing discomfort and painful symptoms which can include:

• Pain that radiates down through your buttocks, hips and legs typically – you might experience this as a mild ache, burning sensation or shooting pains (the pain can vary from person to person).
• The feeling of irritation, pins and needles or a painful tingling down your buttocks, hips and legs.
• Very occasionally weakness in your legs or feet. 

What causes sciatica during pregnancy?

The causes of sciatica during pregnancy are often multifactorial and different for every woman and pregnancy. 

There are several underlying causes that can irritate the sciatic nerve, including:

• Normal pregnancy-related changes affecting your muscles, ligaments and joints, typically impacting on your lower back, spine and pelvis.
• Your body producing a hormone called Relaxin which relaxes your joints, muscles, ligaments and helps your pelvis to expand in order to accommodate your growing bump and prepare you for child birth.
• The position of your baby and the way that your body distributes the extra weight you are carrying.
• Changes and adjustments to your posture and the way you move around day-to-day.
• Underlying weaknesses or having back pain or sciatica before the pregnancy. 

Physiotherapy for sciatica during pregnancy

Physiotherapy is an effective treatment for pregnancy-related sciatica. 

Your physiotherapist will conduct a thorough assessment to identify the underlying cause of your sciatica. Identifying the root cause when you are pregnant is important because it will enable them to create an appropriate treatment plan that can help to stop or reduce the pain, as opposed to just treating the symptoms. 

This treatment plan will also help you to manage your sciatica as your pregnancy progresses and prevent your sciatica from returning or worsening. 

Physiotherapy treatment for pregnancy-related sciatica with an Ascenti physio may include:

• Soft-tissue massage – Your physio may use a range of different soft-tissue massage techniques, typically applied to your lumber spine and gluteal muscles while you lie on your side to reduce muscle spasms and any tightness around the sciatic nerve. This is not the same as a holistic massage or a sports massage; this is targeted physiotherapy treatment that will form one part of a wider treatment plan.
• Stretches – Flexibility work and stretching within pain limits can help to reduce tension and improve mobility, which can reduce irritation to the sciatic nerve. Stretching has the potential to improve the pain of sciatica for some people but can make it worse for others, depending on the root cause of the sciatica, so it’s important to seek exercise advice from a physiotherapist.
• Exercise therapy – Sciatica can often be improved by building up the strength and stability of the lower back, glutes and hamstrings during pregnancy. This is because the extra weight from your baby can sometimes put pressure on areas connected to the sciatic nerve if you do not have adequate strength and stability in those muscles. 

If needed, your physiotherapist will prescribe exercises for you to follow at home. They will use our patient app to provide you with exercise instructions and a treatment plan, where you will be able to access demo videos, track your progress and send messages to your physio after your appointment. This is a great tool as it gives you 24/7 access to guidance at the touch of a button and the confidence to know that you are doing your exercises correctly. 

• Brace support – Your physiotherapist may recommend wearing a brace around your lower back to support your lumbar spine. This can help to reduce pain and irritation to the sciatic nerve.
• Lifestyle advice – Your physiotherapist will also talk to you about your lifestyle and discuss adjustments that could improve your sciatica. For example: posture advice for at work or changing the way you complete every-day tasks such as lifting. 

If you are looking for obstetrics related physiotherapy (antenatal or postnatal care) please call our customers services helpline (0330 678 0850) for a remote initial assessment with one of our specialist trained therapists. They will assess your symptoms virtually and ensure you continue your treatment with the most appropriate therapist for your needs.

Please note we cannot support the following conditions:

• Caesarean section – scar site management advice
• Sexual Dysfunction – vaginismus/dyspareunia
• Transgender care
• Perineal tears

Can you have physiotherapy when pregnant?

Yes. Physiotherapy is a safe and effective way to treat sciatica during pregnancy.

Your Ascenti physiotherapist will take into account your pregnancy and will adapt their treatment approach to ensure that it is safe for you and in line with the latest best practice guidance. For example, you would lie on your side for soft-tissue massage. 

If you book an appointment with Ascenti you can rest assured that you are in good hands. We are a trusted partner to the NHS and all Ascenti physiotherapists are registered with the Health and Care Professions Council (HCPC). 

Ascenti is also registered with the Care Quality Commission (CQC), the same organisation that regulates hospitals and primary care services. Learn more about our quality and safety standards. 

Some physiotherapists also choose to specialise in women’s health which covers all conditions associated with pregnancy, post-natal recovery and pelvic conditions.

At Ascenti we do have some women’s health specialists and you can contact us to find out if we have one working near you. 

How long will it take until I feel better?

At Ascenti we typically treat pregnancy-related sciatica in 4-6 physiotherapy sessions.

Because sciatica is not a diagnosis, recovery can vary from person to person depending on the underlying causes of your sciatica during pregnancy. 

For some people, treatment may rehabilitate them very quickly and stop the pain. For others, it might be more a case of regular soft-tissue massage to relieve pain and improve mobility, alongside strength-building exercises and techniques to help manage and prevent the sciatica from worsening as the pregnancy progresses. 

To rehabilitate fully and as quickly as possible, it’s important that you follow the advice of your physiotherapist, stick to your exercise plan and make any lifestyle adjustments that have been recommended.  

How can I manage the pain of sciatica at home?

If you are experiencing the sudden onset of sciatica symptoms during pregnancy or what some may refer to as a ‘flare up’ it can be extremely painful. 

The below will only help you to manage sciatica symptoms. You should book an appointment with an Ascenti physiotherapist so that they can identify the underlying causes and give you a treatment plan that will fully address your sciatica and reduce or stop the pain. 

Advice for the sudden onset of severe pain from sciatica: 

• Use heat or ice – Many people find that heating the lower back, hip or leg with a hot water bottle can relieve the pain, but some also find cooling the area helpful. Be cautious about overheating your belly or burning your skin. Read our using heat and ice at home page for more guidance.
• Get comfortable - If you have already seen an Ascenti physiotherapist they will have discussed a treatment plan with you and a way to manage the pain, including advice about finding a comfortable position. Lying on the side of your body where you do not feel the sciatica and with a pillow in-between your knees can be a comfortable way for many pregnant women to rest or sleep.
• Ask for help – If you already have a small child to look after or strenuous work to do then you should ask for some help and support. It goes without saying that you should avoid lifting and any strenuous activities when the pain is very bad.
• Relax - If you can, try to relax. Reducing stress and anxiety can have a big impact on conditions like sciatica because it affects your nervous system, and your mental and physical health is closely connected.
• Painkillers - Taking painkillers with the advice of your pharmacist, doctor or midwife will help you to get comfortable and relax, which can be important for a good night’s sleep and recovery. The NHS recommend that paracetamol is safe to take during pregnancy.
• Stay as active as you can – If you are having a bad day then it goes without saying that you should rest, but once you feel able to you should try to move as normally as you can within your pain threshold. 

Is massage good for sciatica during pregnancy? 

Massage can help a little bit, but massage alone is not the answer. 

To treat sciatica properly you need a complete rehabilitation plan and to identify the root cause with a physiotherapist. There is no point in just treating the symptoms with massage which can provide some relief, but not addressing other issues that could be causing it such as your posture or an underlying weakness. 

Depending on what’s causing your sciatica, massage could form one aspect of your physio treatment plan with us, but this will not be the same as a holistic or sports massage. 

Physiotherapists will use targeted soft-tissue massage techniques to reduce muscle spasms and any tightness around the sciatic nerve, and this will always be combined with other treatments approaches.  

What physio exercises can help sciatica during pregnancy?

Often the best exercises for sciatica during pregnancy involve strengthening your glutes, hamstrings and lower back. 

Strengthening these areas can help you to carry the extra weight on your front and reduce pressure on your lower back and sciatic nerve.