What is sciatica? What causes it during pregnancy? We share this + our TOP SOLUTIONS FOR SCIATIC NERVE PAIN RELIEF DURING PREGNANCY... including pregnancy safe sciatica stretches and key changes to implement!
Pregnancy creates a perfect storm for low back and pelvic pain as women experience sudden weight gain with baby growth, posture // gait changes, and hormone changes that affect ligament laxity [ relaxin levels increase during pregnancy, contributing to this ]. One of the conditions that can occur in this area is ‘sciatica’. Sciatica is a catch-all term for pain that is stemming from the sciatic nerve — the longest nerve in the body. The nerve is created by the lumbar and sacral nerve roots [the nerves that exit the spinal cord in the low back] and travels down as a thick cord underneath a tiny muscle — the piriformis [pictured below].
Sciatic pain during pregnancy is often caused or triggered by tension in the piriformis muscle. The piriformis muscle is one of the outside rotators for the hip, attaching at the back edge of the tailbone & extending to the outside of the femur [thigh bone]. When it becomes tight it actually compresses the sciatic nerve tracking underneath it causing pain in your backside that can extend down the back of the leg. During pregnancy, there are certain posture changes that place extra stress and tension on certain muscles, like the piriformis. The center of gravity shifts forward, or anteriorly, as baby grows in size. With the shift in the center of gravity, the pelvis also tips or tilts forward. Anterior pelvic positioning makes it more difficult for other, larger glute muscles to work, so the piriformis takes over. The result is an overworked, tight piriformis muscle with an underworked glute medius.
Although there are other causes to sciatica pain [like disc herniations in the low back], compression of the sciatic nerve by the piriformis muscle is the most common cause of sciatica in pregnant women!
During pregnancy, the body shifts in tremendous ways to accommodate the growing baby. One hallmark is the pelvic movement. Your pelvis is made of two large bones that connect to either side of the sacrum [also termed SI joint]. This area is responsible for transferring forces from the spine into the pelvis and lower extremity. As pregnancy progresses and baby grows, the pelvis tilts forward, which places more stress on both the SI joints and low back.
Since the piriformis muscle attaches to the edges of the sacrum and extends across the pelvis to connect to the thigh bone, SI misalignment can lead to piriformis tightness or spasm, as well as asymmetrical motion that can worsen symptoms.
Chiropractic adjustments create proper mobility + alignment in these joint spaces, thus taking pressure off + decreasing pain. The Webster Technique is another component to chiropractic care during pregnancy that adds additional benefits with specific adjustments and soft tissue techniques.
Flexion distraction is a chiropractic technique we utilize in the clinic for numerous conditions, one being sciatica pain during pregnancy. This technique involves gapping the spinal joint segments, creating movement and hydration to to the joints and disc spaces. This motion assists in flossing the sciatic nerve. Nerve flossing or nerve gliding involves assisting the nerve so it more easily glides between tissues. Flexion distraction is also a great tool if sciatic pain is stemming from a disc herniations or disc problem, as it opens and creates space the spinal joints.
If you know CHIRO FOR MOMS, you know one our all time favorite tools is an exercise ball! Utilizing an exercise ball for sitting [ rather than your desk chair or couch ] reliefs pressure off of the sciatic nerve + piriformis muscle. Additionally, it forces a better sitting posture and allows for a less static position. We encourage you to incorporate stretches with your exercise ball, like the one we go over below as well as pelvic motions while using your ball [like small pelvic tilts and figure 8’s]. If you are looking to get your own exercise ball, we have great suggestions on our Pregnancy Must Haves List.
Stretching and lengthening specific muscles, like the piriformis and iliopsoas, is key to sciatica pain relief during pregnancy. Follow along with the video for a 10 minute pregnancy sciatica stretching session!
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Nerve flossing is a simple, pregnancy safe technique to start relieving sciatic pain during pregnancy. You can use nerve flossing exercises for all types of nerve pain, but for sciatica, its all about gentle movement in the lower leg. By following this flexion and extension movement, we are stretching the sciatic nerve and encouraging it to glide properly.
Utilize a tennis ball to release tension in the piriformis muscle. Relieving tension from the piriformis will also relieve pressure off the sciatic nerve. Adding movement with the leg will intensify this sciatic pregnancy stretch!
Since the piriformis plays just a big role in sciatica during pregnancy, we like to target stretching it in a few different ways. This lying piriformis stretch adds in truck rotation to stretch not only the piriformis but other low back muscles. To avoid laying completely flat, your can use a wedge pillow!
Like we mentioned earlier, you can use your exercise ball for more than just sciatic relief while sitting! Use your exercise ball for pregnancy safe stretches, like the one we demo in the video! This specific exercise ball stretch targets pregnancy sciatic pain by lengthening the side body and glute muscles.
The iliopsoas muscle attaches to all the segments in the low back and the outer hip. Posture changes, mostly the anterior tilt of the pelvis, causes extra tension to be placed on this muscle. This is the standing option to stretch this hip flexor muscle during pregnancy!
For some women, sciatic symptoms resolve postpartum as the stressors are relieved from pregnancy. However, other women may continue to experience pelvic or sacroiliac joint pain during their postpartum period. For these women we recommend continuing chiropractic care, working on postpartum pelvic mobility, and looking into physical therapy to focus on pelvic stabilizing exercises.
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