Low back pain is extremely common, affecting some 70-80% of the population. Low back pain is particularly prevalent during pregnancy. The main cause of this is the change in weight bearing and the change in hormones.
As the baby grows the spinal curves change, and usually adapt very well, but sometimes there is a little discomfort with the change in posture. This usually resolves quickly with manual therapy and gentle exercise, but it can occasionally put pressure on certain nerves in the lower back. When this happens you will experience ‘neurological’ symptoms, and simple ‘non-specific’ low back pain becomes ‘sciatica’.
As the hormone levels change you will also experience ligament laxity and a feeling of instability in the joints. This can cause muscle stiffness, particularly around the lower back and buttock region. The laxity is important, as it will help your pelvis to open when it comes to delivering your baby.
In the meantime you should find a way to alleviate the discomfort and gently stretch the tight muscles. This might include antenatal yoga, osteopathy, rolling a tennis ball in to the area to self-massage, a warm bath or swimming. (Take care with treatments during your first trimester – your practitioner should discuss this with you)
What is sciatica?
Sciatica is caused by irritation and inflammation of the nerves in the lower back. These nerves group together and travel down the leg to form the sciatic nerve.
Between every vertebra in our back we have discs. These discs are responsible for load bearing and act a bit like a cushion – as your weight increases and spinal curves change they are put under more pressure, and can sometimes be responsible for the irritation of the nerves. One aim of osteopathic treatment is to reduce the pressure on the discs and try to clear some of the inflammation around the irritated nerve.
For most patients it is advisable to keep moving where possible and seek advice regarding exercises that are appropriate for you. There are other causes of sciatica so the first step is to get a diagnosis from a healthcare practitioner, such as an osteopath.
Is my lower back pain sciatica?
Some symptoms of sciatica include:
- Low back pain
- Tightness in buttocks and low back
- Pain down one leg in to the foot
- Pins & needles in the toes
- Tripping over your foot
- Numbness down the leg or in the toes
If you experience any numbness in the genital area, urinary or faecal incontinence, severe pain down both legs call 111 or go to A&E immediately.
What you can do to relieve sciatic pain?
Sciatic pain will not harm your baby and will get better with time. It usually takes around 4-6 weeks to fully resolve but can last longer. Seeking professional advice can help you to identify any ‘maintaining factors’, or things that might be aggravating symptoms. Making a few simple changes and gently moving usually relieves the pain.
Simple changes to make:
- Keep moving and don’t sit for long periods without taking a break
- Gently stretch the body on your own or in an antenatal class
- Stay relaxed as stress heightens pain levels
- Drink plenty of water
- Try self massage or pregnancy treatments
- Sleep with a pillow between your knees
- Set up your desk properly at work
- Adjust your car seat so your hips are above your knees and you aren’t in a ‘bucket’ position – sitting on a cushion might help
- Speak to your GP about pain relief if needed
- Perform pelvic floor exercises daily
- Try foam rolling the buttock area
About the author
Holly Siddall is a registered osteopath and medical acupuncturist in London. She also works as a Visiting Master for the Four Seasons Resorts treating patients all over the world including the Maldives, Thailand and the Seychelles.
Holly Siddall Ltd
61-63 Sloane Avenue, Chelsea, London, SW3 3DH
71 Englewood Road, London, SW12 9PB