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Healthy and Active Pregnancy

Sciatica

10/5/2017

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Sciatic Nerve Pain (Sciatica)
            The Sciatic nerve is a large nerve that runs from the lower spine, through the buttocks, into the back of the thigh, down through your leg and into the foot (you have 1 on each side).  The sciatic nerve provides motor and sensory input to the legs; it provides sensation to the back of the thigh, lower leg, and the sole of your foot.
            The sciatic nerve can be affected during pregnancy since it runs under your uterus as it goes to your legs.  The pressure from the growing uterus and developing baby can compress the nerve and cause sharp pain, tingling, burning, numbness, or electric-like pain. The pain usually starts in the low back or buttocks (depending where the nerve is compressed) and radiated into the back of the thigh and lower leg/ foot. Sciatic nerve pain is usually one sided.
       Sciatic nerve pain is usually worse when standing or sitting still (adding increased compression over time) and feels better when walking or lying on the side opposite of the one in pain
Picture
Sciatic Nerve Pain can be treated several ways:
            -Warmth to the painful side (shower or warming pad)
            -Walking around to avoid standing still for long periods of time
            -Laying down on the opposite side
            -Physical Therapy for manual techniques to relieve pressure on the nerve
            -Exercise and stretching

Expand for Pictures and Instructions to address Sciatica Pain

Seated Piriformis Stretch
The Piriformis is a muscle that is deep in the buttocks. When the piriformis is tight, it can compress the sciatic nerve and cause pain down the buttock and leg. Stretching the piriformis can help relieve muscle tightness, sciatic nerve compression, and pain.
 
-Sit on a chair with your feet flat on the ground
            *Keep a neutral spine
-Put the ankle of the affected side on to the opposite knee
-Lean forward while keeping your back straight until you feel a stretch through the buttocks
            *Hold for 30 seconds.
            *Repeat this throughout the day as long as pain does not get worse

Table Stretch
This stretch targets the muscles in your back, buttocks, and thighs
 
-Stand with your feet shoulder width apart, neutral spine, and hands on a table or back of chair
-Lean forward while keeping your arms straight out and your back flat
-Pull your buttocks back until you begin to feel a stretch in your back, buttocks, and back of your legs
            *Hold for 30 seconds or until you feel an adequate stretch
            *Repeat throughout the day as long as pain does not get worse

Hip Flexor Stretch
This stretch targets the muscles at the front of your hip
 
-Start in a kneeling position on your hands and knees
-Bring your leg forward and step on one foot so your hip and knee form a 90 degree angle
- Bring your weight forward until you feel a stretch in the front of your back hip/leg
            *Hold for 30 seconds
            *Repeat on opposite side

Pigeon Pose (with roll modification)
This pose can help relieve pain in the hip area, it targets the hip flexors and hip rotator muscles.
 
-Start in a kneeling position on your hands and knees
-Bring your left knee forward so that its between your hands
            *You can place a towel behind your buttock/ hip if you are particularly tight
-Bring the right leg back with foot on the floor
-Lean forward over your knee and slowly lower yourself toward the ground 
            *Prop yourself on your hands, you can lean as far forward as you feel comfortable
            *Hold for 30 seconds or as long as you feel comfortable, and then switch sides

Supine Sciatic Stretch 1
This stretch helps loosen gluteal muscles and piriformis, you can also stretch the hamstrings using Variation 2
 
-Lay on your back with your feet flexed up
            *If uncomfortable, you can place a pillow or wedge behind your head/shoulders
-Bring your knee to chest until you feel a stretch (but no pain)
            * Variation 1: You can bring the knee across toward your opposite shoulder for more of a stretch
            * Variation 2: You can straighten your knee to get a deeper stretch across your leg
-Keep the stretch for 30 seconds, or as long as it feels comfortable to you; it should not feel painful
 
**Do not be on your back for more than 30-60 sec after the 1st trimester in order to avoid compression of the vena cava

Supine Sciatica Stretch 2
This stretch helps loosen gluteal muscles, hamstrings, and piriformis. It also helps loosen your lower back
 
-Lay on your back with your feet flexed up
            *If uncomfortable, you can place a pillow or wedge behind your head/shoulders
-Bring your leg across your body until you feel a stretch
            *You shouldn’t feel any pain in your back or legs, if you do, then discontinue
-Keep the stretch for 30 seconds or as long as it feels comfortable; it should not feel painful
           
**Do not be on your back for more than 30-60 sec after the 1st trimester in order to avoid compression of the vena cava


Foam Roller for Gluteal Muscles and Hamstring Muscles
Foam Rolling is a good way to “massage” hard to reach muscles in order to soothe and relax them if they are tight and painful. Foam rolling may cause some pain if your muscles are very tight, in that case, lessen the pressure between foam roller and muscle. You want to feel a massaging sensation, but it shouldn’t be extremely painful
 
-Sit on a foam roller with your hands behind you for support
-Cross your foot over your opposite knee
-Move yourself slowly back and forth on the foam roller until you find a tender spot
            *Stay at this spot for 30-60 seconds, making small rolling motions
-Continue moving the foam roller until you find another tender spot 
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    Elina Skripochnik PT, DPT, CSCS

    Elina is a Physical Therapist with experience in women's health and pediatrics. She aims to educate women on the importance of becoming and staying active during pregnancy, as well as to provide safe and easy exercises that can be done throughout pregnancy and beyond. 

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