Sciatica during pregnancy affects nearly 1 in 5 expectant mothers, causing sharp, shooting pain that radiates from the lower back down through the legs. It can make simple activities like walking, sitting, or sleeping feel impossible.
You’ll find plenty of advice online suggesting ice packs, heating pads, or gentle stretches, but as a pelvic floor physical therapist, I’ve seen over and over again how stretching exercises can actually make sciatic nerve pain during pregnancy much worse.
However, there IS a way to relieve sciatic pain for pregnant women, and in this article, I’ll share everything you need to know on this topic, plus exercises you can safely try at home!
Sciatica develops when the sciatic nerve, which is the longest nerve in your body, becomes compressed or irritated. This nerve runs from your lower back, through your pelvis and buttocks, and down each leg.
During pregnancy, a few different factors can put pressure on this nerve, causing sciatic symptoms and pain.
For starters, your growing baby and expanding uterus shift your center of gravity forward, changing how your spine curves and how weight is distributed through your pelvis.
Plus, pregnancy hormones like relaxin loosen ligaments and joints throughout your body. These changes can create instability that allows bones, muscles, or swollen tissues to press against the sciatic nerve.
Sciatica symptoms include:
Sciatica pain during pregnancy usually affects one side more than the other, and can be VERY debilitating. It can also come as a complete surprise if you’ve been active and generally fit before, such as for this mama I saw on Reddit:
I often hear from the moms I work with that their sciatica “came out of nowhere.” It’s usually the straw that breaks the camel’s back = it hits you suddenly when you bend down to pick something up.
Experiencing this sucks, BUT I want to make it very clear that it IS possible to relieve sciatic nerve pain during pregnancy, and the main way to do that is physical therapy.
No, sciatica isn’t a normal part of pregnancy. In general, any type of severe pain or discomfort isn’t normal during pregnancy.
Research shows that 17% of women experience sciatica during pregnancy, though this number may be higher since some cases go undiagnosed or are dismissed as typical pregnancy aches.
However, just because sciatica is relatively common, it doesn’t make it normal or something you should accept as inevitable.
During my first pregnancy, I had horrible sciatica pain, and I had no idea how to manage it. However, with my second and third pregnancies, I only had ONE episode of sciatica that I was able to resolve within days with physical therapy.
It never came back, and I’ve helped hundreds of women get rid of sciatica during pregnancy and beyond as a pelvic floor PT.
No, and they can often make the radiating pain and other sciatica symptoms worse. As a pelvic floor PT, I don’t recommend sciatica stretches during pregnancy. Stretches can help relieve the pain for a little while, but they don’t resolve the underlying cause.
Many women have underlying alignment issues and muscle imbalances that existed before pregnancy. These problems might not have caused pain before, but pregnancy amplifies them.
With the hormonal changes loosening your joints, pregnancy weight shifting your center of gravity, and postural changes putting new stress on your spine and pelvis, what was once manageable becomes painful and obvious.
Also, many women are less active and strong during pregnancy, so they don’t have the same amount of stability in their bodies as before.
Stretching can make things worse by further destabilizing areas that need more stability and support, not more flexibility. Instead, to alleviate sciatica symptoms, you should focus on better spinal alignment and strengthening your core muscles.
Physical therapy is the best way to treat sciatica pain during pregnancy. The exercises that your physical therapist will give you should focus on:
Pregnancy support belts can also help by lifting and supporting your belly. This will reduce the downward force on your spinal cord and pelvis and help alleviate the pressure on your sciatic nerve.
Here are my favorite belly bands, and other pregnancy + postpartum products!
Lie on your right side with a small ball between your knees. Support your head with your hand and bend your knees and hips to 90 degrees. Gently tuck your pelvis under you (small pelvic tilt) and engage your deep core muscles.
You should feel the engagement of your inner thigh and deep core with each squeeze.
You should do this exercise lying on your right side and pulling your left leg back because this is typically the hardest side to do this on.
Get on your hands and knees with a ball between your knees. Place your hands directly under your shoulders and knees under your hips.
Sit in a chair with a ball between your knees.
Now, sit in a chair and place a resistance band around your knees.
Alternate between ball squeezes and band exercises throughout your session.
Sciatica often develops during the third trimester when your baby is larger and putting more pressure on your sciatic nerve. However, some women experience it earlier in their first or second trimester.
Most of the time, sciatica goes away after delivery once the pressure from your baby is gone. Very severe sciatica can linger for a little bit after birth.
However, sometimes women will develop sciatica months or even years after birth.
Not addressing pelvic floor and core issues during pregnancy can lead to sciatica and other issues postpartum, such as persistent back pain, pelvic floor dysfunction, diastasis recti, and ongoing hip pain.
The physical therapy work you’ll do to relieve pain from sciatica can help prevent other issues from developing as your pregnancy progresses and in the early postpartum period.
You can sleep on your side with a pillow between your knees to keep your hips aligned. Some women also find it helpful to place another pillow under their belly for support.
However, the best thing that you can do to sleep better at night is to address the root causes of sciatic nerve pain.
Sciatica most commonly starts in the third trimester, typically around weeks 28-32, when your baby is large enough to put a lot of pressure on your sciatic nerve. However, some women also start developing sciatica as early as the first or second trimester.
A common time frame is just at 13 or 14 weeks, which is when the first spike of the hormone relaxin happens (this has always shocked me!).
Walking can be helpful for sciatica as long as it doesn’t make the pain worse. However, it’s not a way to treat the condition, so make sure to combine walking with physical therapy exercises. Some medical providers position walking as a magic cure for sciatica, but it’s not.
Yes, you can have a vaginal birth with sciatica. It doesn’t require a C-section. However, you should discuss comfortable labor positions with your healthcare provider or midwife, such as side-lying or hands-and-knees positions that may feel better for your back.
Good posture, alignment, and core stability are all very important. Consider seeing a pelvic floor physical therapist early in pregnancy, especially if you have a history of back pain or previous pregnancies with sciatica.
When I was in high school, I was told that pregnancy would kill my back and come with unbearable pain because of my existing back injury. But with my second and third pregnancies, my back pain was non-existent, and I fully managed sciatica with physical therapy.
You CAN reduce and even eliminate sciatica pain during pregnancy and other common woes through intentional and evidence-based pelvic floor physical therapy.
If you’re looking for:
My online physical therapy program, Strong Expecting Mama, helps with pregnancy, labor, and postpartum. Each class only takes between 15 and 20 minutes, and you get direct access to Dr. Anna (me! 👋) to ask questions!
Learn more about Strong Expecting Mama and join!