Pinched sciatic nerve during pregnancy in the 2nd and 3rd trimesters: what to do, how to treat

Pregnancy is a difficult time for any woman. Serious changes occur in the body, as a result of which pathologies of various tissues can be observed. Carrying a child has a particular impact on the tissues of the spinal column. The functional parts of the autonomic nervous system are also affected. The sciatic nerve during pregnancy often finds itself in an area of severe compression. In severe cases, its atrophy is even observed, as a result of which the woman then loses sensitivity in certain parts of the lower limb for the rest of her life.

In this article you can learn about why the sciatic nerve is pinched during pregnancy and what you can do to alleviate your condition and prevent the risk of developing serious complications.

Let's start with an excursion into anatomy and physiology. The spinal column of any person is conventionally divided into five sections. Each differs in vertebral structure and functionality. For example, the lumbar region is the most massive, since the conditional center of gravity is located here and the maximum shock-absorbing load occurs here when performing any body movements.

Associated with the lumbar, the sacral part of the spinal column is a single triangular bone. But until the age of 23–25 years, these are five separate vertebral bodies. Gradually they grow together. Therefore, during pregnancy over the age of 25, there is a high probability of developing sciatica (pinched sciatic nerve). The plasticity of tissues is lost.

In the spinal canal in the lumbar spine there is a segment of the spinal cord of the same name. In the sacral region there is the terminal section of the spinal cord; threads extend below, which participate in the formation of the cauda equina nerve plexus.

The areas of the spinal cord located above the filum terminale give rise to radicular nerves, which arise through the lateral foraminal openings of each vertebral body. They branch and form the lumbosacral nerve plexus. And from it come large nerves responsible for the innervation of the lower extremities and abdominal organs.

Among them is the sciatic nerve. Immediately after leaving the lumbosacral spine, it enters the pelvic cavity, then exits near the entrance to the piriformis muscle tunnel and descends along it to the trochanter of the hip joint. Next it follows between the muscles of the back of the thigh to the popliteal fossa. Here is its point of bifurcation (division) into two branches (tibial and fibular). They descend to the ankle joint along the lateral surfaces of the lower leg and participate in the innervation of the tissues of the foot.

To ensure uniform distribution of the shock-absorbing load, the spinal column is equipped with intervertebral discs and physiological curves. The paravertebral muscles and the muscular frame of the back and lower back are also called upon to help.

Intervertebral discs consist entirely of cartilage tissue. This is the fibrous ring (a dense and elastic membrane). And the internal gelatinous jelly-like body (nucleus pulposus). The intervertebral disc does not have its own blood supply and receives fluid and nutrition only when the paravertebral muscles systematically tense and relax.

If they do not work, then the cartilage tissue becomes dehydrated, becomes brittle, and undergoes cracking and calcification. This process is followed by destruction of the intervertebral disc. This and many other things can cause a pinched sciatic nerve during pregnancy.

It is important to understand that only the elimination of nerve fiber compression factors can achieve a positive result from the treatment. Only an experienced vertebrologist or neurologist can identify potential negative factors. During pregnancy, it is not advisable to carry out X-ray and MRI examinations, since this can cause harm to the baby’s health. Therefore, very accurate manual diagnosis is necessary.

If you suspect that the sciatic nerve is pinched during pregnancy, we recommend that you immediately seek medical help from a vertebrologist or neurologist. In Moscow, you can visit these specialists completely free of charge in our manual therapy clinic.

Causes of sciatic nerve pinching in the 2nd and 3rd trimester of pregnancy

Most often, women complain that the sciatic nerve is pinched during pregnancy, in the 2nd and 3rd trimester of pregnancy. This is due to the fact that by this time significant changes are observed in the pregnant woman’s body.

The sciatic nerve during pregnancy in the 3rd trimester can be pinched due to the pressure exerted by the growing uterus. But these clinical cases account for no more than 20%. All other situations are associated with certain risk factors that are present in the woman. Thus, pinching of the sciatic nerve during pregnancy in the 3rd trimester will most likely be observed if:

you are overweight (any increased body weight means serious pressure on all tissues of the spinal column);
the recommendations of the attending physician on hygiene during pregnancy are not followed (flat shoes, wearing a prenatal bandage, diet, etc.);
the sleeping and working space is improperly organized;
there is no constant monitoring of posture;
there is lifting and carrying heavy objects;
a woman is engaged in heavy physical labor;
there are systemic diseases of cartilage tissue;
there are pathologies of the endocrine system (diabetes mellitus, thyroid dysfunction, etc.).

All of these risk factors should be eliminated from your life if possible. Before starting treatment, an experienced doctor takes a medical history. Based on its results, he gives the patient just such an individual recommendation. It lies in what a woman needs to change in her lifestyle and diet in order for the treatment to take place in a short time and give a positive result.

The sciatic nerve is very often affected during pregnancy in the 2nd trimester, this is due to several factors. Potential causes of this condition may include the following:

softening of cartilage tissue under the influence of a large amount of female sex hormones;
divergence of the pelvic bones (in case of multiple or polyhydramnios pregnancy);
gestational diabetes mellitus with concomitant neuropathy and angiopathy;
degenerative dystrophic disease of the cartilaginous tissues of the intervertebral discs (osteochondrosis) and accompanying protrusions, extrusions and intervertebral hernias;
violation of posture and smoothing of the physiological lumbosacral curvature of the spinal column;
change in foot placement due to increasing body weight (flat feet or club feet are often observed);
piriformis syndrome (pinching occurs inside the piriformis tunnel);
compression of the sciatic nerve at the point of its bifurcation (in the popliteal fossa) - is associated with nephropathy, eclampsia, accompanied by severe edematous syndrome of the legs.

Other causes of pinching of the sciatic nerve during pregnancy can be infectious and tumor processes, displacement, twisting, distortion of the pelvic bones, and traumatic effects.

For differential diagnosis, it is important to exclude the possibility of developing deforming osteoarthritis of the hip and iliosacral joints. These pathologies are often debated during pregnancy. This is especially common among women who decide to have a child over the age of 35. They also have a high likelihood of developing osteomalacia and osteoporosis due to a deficiency of vitamin D, a large amount of which the growing fetus needs.

Causes

According to statistics, about 70% of women suffer from the disease in different trimesters to varying degrees. This is associated with diseases affecting the intervertebral discs. There are a number of other factors.

Weight gain, which increases the load on the spine.
Excessive fluid retention in the body - pressure on the sciatic nerve increases.
Dilation of the uterus.
Displacement of the center of gravity with breast and abdominal enlargement.
Relaxed joints. The hormone relaxin, which relaxes the muscle tissue in the pelvic area, makes the ligaments more elastic, which increases symptoms.

Third-party factors can play a significant role in the manifestation of unpleasant symptoms. Women in the 3rd trimester experience pain when the baby is in the correct position.

Only a doctor after an examination can determine the root cause of why sciatica appears during pregnancy.

Symptoms of sciatic nerve pain during pregnancy

It is impossible not to notice that the sciatic nerve hurts during pregnancy, since this condition is accompanied by severe pain in the sacral area. They radiate along the back of the thigh, radiate to the heel, etc. During pregnancy, when damaged, the sciatic nerve can provoke a change in gait, since its branches are responsible for the innervation of those muscles that provide flexion and extension of the leg at the knee joint. Therefore, a characteristic “dragging” of the lower limb may appear, which is difficult not to notice from the outside.

Clinical symptoms that the sciatic nerve is affected during pregnancy may include the following:

impaired ability to lean forward (a strong muscle tension is felt in the sacrum and lower back);
shooting along the back of the thigh and lateral surfaces of the lower leg;
it hurts to step on the heel on the affected side;
areas appear on the leg with impaired sensitivity;
the skin on the leg becomes pale, dry and cold to the touch (this indicates that the innervation of the vascular bed is impaired);
paresthesia appears (feeling of crawling, tingling, etc.);
muscle strength of the lower limb decreases, increased fatigue and even pain in the calf muscles appear while walking.

There may be other symptoms. For example, it is difficult to move your leg to the side while standing. When palpating the affected areas, muscle fiber tension and pain are determined. Tendon reflexes may be decreased.

What to do if the sciatic nerve is pinched during pregnancy

The first thing to do if the sciatic nerve is pinched during pregnancy is to refuse any physical activity. Rest, unloading the back muscles, sleeping on a hard, flat surface on the back help relieve pressure from the sciatic nerve. But only if some serious pathology does not develop.

Therefore, if your sciatic nerve does not pass during pregnancy, the next thing to do is to look for an experienced spine specialist. For this, we strongly recommend that you contact a manual therapy clinic at your place of residence. There, as a rule, doctors have extensive experience in providing assistance to pregnant women for such conditions. No pharmacological drugs are used and the treatment is completely safe for the expectant mother and her baby.

It is also important to understand what to do if the sciatic nerve is pinched during pregnancy, and there is no opportunity to visit a doctor right now. So, categorically refuse to take any painkillers. They do not cure, but only mask clinical symptoms. Most of these drugs are contraindicated during pregnancy at any stage. It is best to lie on your back, relax all the muscles of your back and lower back. And lie in this position for at least half an hour. If it does not help, then emergency assistance from a specialist is required.

Treatment of the sciatic nerve during pregnancy

Treatment of the sciatic nerve during pregnancy can only be done using manual therapy methods. You should not take medications. It is important to find an experienced doctor who will develop an effective and safe course of therapy. It may include osteopathy, massage, therapeutic exercises, kinesiotherapy, reflexology, etc.

Proper treatment of the sciatic nerve always begins with the doctor identifying the potential cause of its damage. For example, this is a violation of posture due to smoothing the physiological curve of the lumbosacral spine. In this case, therapy aimed at strengthening the muscular frame of the lower back will help. This procedure will correct posture, relieve the tissues of the spinal column, and eliminate pain.

In case of degenerative dystrophic damage to the cartilage tissue of the intervertebral discs, a procedure for manual traction of the spinal column may be indicated. It allows you to relieve compression from the radicular nerve, the branches of which are responsible for the formation of the sciatic nerve.

Be sure to consult a doctor. In Moscow, you can make an appointment for a free appointment with a chiropractor, vertebrologist or neurologist right now in our clinic. To do this, use the registration form located further on the page. Please provide your phone number. The clinic administrator will contact you shortly and agree on a time convenient for your visit.

Treatment

It is necessary to treat sciatica during pregnancy only after a complete examination, with caution so as not to harm the child. Depending on the intensity of the symptoms and the general clinical picture, the therapist or gynecologist selects an individual treatment regimen.

Medicines

For severe symptoms, painkillers are prescribed. Paracetamol or ibuprofen based drugs are used. They do not have a negative effect on the fetus.

The course of treatment is 1 week. The dosage is determined by the doctor in accordance with the disease, period, and nature of pregnancy.

The inflammatory process is controlled with topical medications. These include creams, ointments, and gels. They do not have a negative effect on the child and help to quickly relieve pain.

Vitamins, muscle relaxants, and chondroprotectors are prescribed as additional medications. They help relax muscle tissue and reduce pain. Only a doctor can prescribe medications. Expectant mothers are strictly prohibited from using them on their own.

Folk remedies

If your back is pinched during pregnancy, and the pain is insignificant, you can relieve it with the help of traditional therapy. Although they are safer than medications, the procedures should be carried out after consultation with a leading gynecologist.

When the sciatic nerve is pinched during pregnancy, your doctor will tell you what to do. But traditional medicine will help reduce the severity of pain.

The most effective ways.

Compresses. They are made from horseradish or garlic, which are grated and placed on cheesecloth. The compress is applied to the affected area overnight. If there is no allergic reaction, honey is used.
Rubbing. They have a quick pain-relieving effect. Radish juice and honey are mixed in equal proportions and rubbed into the affected area with light movements. The procedure is carried out up to 4 times a day. Herbal tinctures with alcohol, garlic, pepper or onion are used. But before using it, it is important to consult a leading gynecologist.
Baths. This method is used only in the initial stages and is completely prohibited in stages 2 and 3.

Sciatica during pregnancy is treated comprehensively. Traditional methods only help relieve symptoms, but do not eliminate the problem itself. They should be used together with medications.

Exercise therapy

Therapeutic exercise is prescribed by a doctor. Loads should be moderate. Exercise therapy is used both to reduce pain and to prevent its occurrence.

The doctor will prescribe exercises depending on the severity of pain, duration, and course of pregnancy. If you experience any unpleasant sensations, deterioration of health, or discomfort, exercise should be stopped.