How can physiotherapy help sciatica in pregnancy?
I suffered from sciatica through my second pregnancy and wished I knew physiotherapy could have helped to ease the pain and discomfort I was experiencing.
When I fell out of my photography studio and tore a ligament (I had a cuppa in my hand, not a glass of wine), I was recommended Katie Gosling, a fantastic physiotherapist based in Cheltenham.
Katie’s treatment room is serene. As soon as I walked through the door, I felt comfortable and relaxed into my treatment.
Katie is so friendly, professional and full of positive energy.
We got talking about my photography business (specialising in newborn photography) and the topic of sciatica in pregnancy popped up.
I asked Katie if she could share some useful information on ‘How can physiotherapy help sciatica in pregnancy?’
I’m am so pleased to have Katie as my guest blogger. Please see below for some insight into sciatic, some great videos of Katie showing you what stretches will help and other therapies that can help sciatica in pregnancy?
Sciatica is a common problem in pregnancy but is not talked about very often. Below Katie Gosling from First Line Physio explains what sciatica is, and provides some simple exercises to help relieve the pain.
OVER TO KATIE
During pregnancy, your body changes a lot in a relatively short space of time, so it’s no wonder it can take such a huge toll on your body. This is especially the case around your lower back and pelvic area.
Photograph by Natural Essence Photography
Due to the weight of the growing baby, women often develop a position of the pelvis known as “anterior pelvic tilt”. This refers to the forward tilting of the pelvis, which causes an increased curvature of the lower back, known as “lumbar lordosis”. This can lead to tightness in the back and hip muscles and problems with the pelvic joints, which can result in sciatica. Some women can have sciatica that is so severe that even walking short distances and getting comfortable in bed is difficult.
It’s important to know that sciatica is not actually a diagnosis, and it is just the term used to describe pain along the course of the sciatic nerve. This originates in the lower back and travels into the buttock and down the back of the leg to the foot. Sciatica can be due to several different causes, and so the treatment for sciatica will largely depend on the cause identified by your physiotherapist.
The 2 most common causes of sciatica in pregnancy are:
This is a muscle located deep within your buttock, which runs from the bottom of your spine across to the top of your thigh bone. This can become tight or spasm in pregnancy, causing pain in your buttock. Sometimes your piriformis can also irritate or compress the nearby sciatic nerve, causing pain down the back of the leg.
Your sacroiliac joint (SIJ) is another cause of sciatica in pregnancy. This is the joint between your sacrum (the bottom of your spine) and your pelvis. During pregnancy, there is an increase in the hormone known as relaxing, which can cause ligaments to loosen. Ligaments connect your bones together and help with joint stability, so the increase in relaxing can lead to increased sensitivity around your pelvic joints. This can irritate or put pressure on the sciatic nerve.
What can I do about sciatica when I am pregnant?
You may be reluctant to take pain relief for sciatica whilst you are pregnant, and you are not alone. Physiotherapy is a fantastic way to get on top of the pain without needing to take any medication, keeping you and your baby safe.
The 3 stretches below can be really helpful to relieve lower back and sciatic pain with pregnancy. It’s a good idea to aim to do them 2-3 times a day, or little and often if the pain is very severe.
- Sitting in a chair, bend one leg up and put your ankle on the opposite knee.
- Allow your top knee to drop out to the side. You can increase this by using your hands to push the knee down.
- Slowly lean forward until you feel a stretch in your bottom.
- Hold for 30 seconds. Repeat 3 times on each leg.
Standing hamstring stretch with a chair
- Stand facing the back of a chair with your feet slightly wider than your hips.
- Hold onto the back of the chair and lean forwards, keeping your arms straight and your back flat.
- Push your hips away from the chair and you should feel a stretch in your lower back and the back of your legs.
- Hold for 30 seconds. Repeat 3 times.
- You can also gently move your hips from side to side to increase the stretch.
Hip flexor stretch
- Kneeling on your right knee, place the other leg in front with your foot flat on the ground, toes pointing forwards and your knee bent.
- Keeping your body upright, slowly bend your left knee and sink into the position until you feel a stretch in the front of your right hip.
- If you want more of a stretch, move the front leg further away so you can sink further!
- Hold for 30 seconds. If it becomes painful then ease off slightly and hold this position. Repeat 3 times on each leg.
Other things that can help with sciatica in pregnancy
Massage can help reduce pain and muscle tightness, improve blood flow and boost your general well-being. Physiotherapists will tailor all massage sessions to you, which usually involves lying on your side rather than your front for your treatment and taking a gentler approach.
You can do some self massage at home with a foam roller or a tennis ball into your lower back and hip muscles.
Acupuncture originated from China many years ago and involves tiny needles being inserted into your body at set points along certain nerve pathways. These are a fraction of the size of a needle used for an injection, so is not as painful as it looks, and most often people don’t even feel the needles going in!
Acupuncture can stimulate nerve endings which can lead to the release of hormones and neurotransmitters, such as endorphins, serotonin and dopamine. This can be very helpful to reduce back pain and sciatica with pregnancy, and is a great alternative to taking pain medication.
It is generally safe to have acupuncture when you are pregnant. Your physiotherapist will go through a series of questions before starting acupuncture, and it is important to let them know that you are pregnant. This is because it is advised to avoid certain acupuncture points when pregnant.
Pain from sciatica can lower your mood, make it difficult to get about and cause sleepless nights. You don’t have to live with it – consider going to see a physiotherapist! It can make a big difference to your pain in a matter of a couple of sessions and keep you going throughout your pregnancy.
This is absolutely not written to substitute medical advice and it is always important to see a qualified health care professional for a formal diagnosis. If any of the exercises cause pain during or after the exercise, discontinue and consult a physiotherapist.
If you would like to get in touch with Katie at First Line Physio please visit their site for more information:
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