Sciatica during Pregnancy

What is sciatica?

First, we must understand anatomy. The largest nerve in your body is the sciatic nerve. The nerve is formed by a combination of multiple nerves. You can see in the picture below that low back nerves and sacral nerves (L4-S3) combine to form one big nerve, the sciatic nerve, that then travels down your leg to supply nerve innervation to your leg muscles. Sciatica is irritation of the sciatic nerve leading to pain, numbness and tingling down the leg. The question then becomes what is compressing or irritating the nerve?

Potential Compression/Irritation areas:

1.     Low back spine- in this area there can be disc or bone pathology. If you have a bulging disc that can press on the nerve creating compression.

2.     Piriformis muscle- this muscle is found under your gluteus maximus muscle and connects your sacrum bone to the hip bone. The sciatic nerve runs under this muscle. If this muscles tightens it can cause signs and symptoms.

3.     Popliteus muscle and upper calf- these muscles can compress the nerves that branch into 2 from the sciatic nerve. 

Now that we understand anatomy, we must look at biomechanics. As a woman progresses through pregnancy the belly grows, and biomechanical changes occur. What does that mean? Our lower back sways more, our center of gravity changes, our mid back rounds more leading to changes in neck position. Increased stress to the pelvis is normal due to our body releasing relaxin hormone to shift the pelvis and slowly widen in preparation for labor. There are 2 things we must look at that can drastically help with these biomechanical changes. 

1.     Pelvic alignment

2.     Muscle strength and stability

We need joints to move and muscles to stabilize those joints as we move. If we lack stability around those joints the muscles will tighten up to stabilize. Let’s go back to the piriformis muscle.  This muscle is pictured below and is important in stabilizing the hips and pelvis. During pregnancy, this muscle tends to become weak, therefore causing the muscle to tighten. Remember a weak muscle will tighten to support joints. If the piriformis tightens it can compress the sciatic nerve leading to sciatic pain and potentially numbness and tingling down that leg.

What do I do if I am having sciatic pain?

            You guessed it, chiropractic care! We are trained to evaluate and treat pregnant women through a specific technique called Webster Technique. This method of treatment effectively restores pelvic alignment. Specific rehab exercises are given to address muscle stability. Schedule an evaluation today and stop suffering from a condition we can effectively treat.

Dr.KS