Sciatica pain relief during pregnancy starts with an actual sciatica diagnosis
If in fact the shooting pain down your leg is sciatica–you’d fall into the 1 percent of women that need sciatica pain relief during pregnancy.
However, that pain in your lower back may not actually be sciatica.
“A lot of people come to physical therapy with a prescription while they’re pregnant for any sort of back or hip pain and it’s assumed to be sciatica. That’s why the most important thing to do during a virtual examination with a new patient is confirm a sciatica diagnosis so the treatment plan addresses the true root cause.”
While sciatica during pregnancy may be rare, that lower back pain you’re experiencing is extremely common–and treatable! Between 50 and 80 percent of pregnant people experience lower back or even shooting pain in the third trimester. Symptoms of sacroiliac joint dysfunction or piriformis syndrome–the pain in your low back or hip due to too much or too little movement in joints of your pelvis–can feel like sciatica but aren't.
The first step to feeling better is getting the right diagnosis. It’s critical to first rule out other common causes of hip pain during pregnancy during an in-person or virtual physical therapy evaluation to confirm a true sciatica diagnosis.
More on Motherly about sciatica during pregnancy, MRIs, and other frequently asked questions.
How does physical therapy help relieve sciatica pain immediately during pregnancy?
As your pregnancy hormones course through your body, one side effect is loosening joints. If your hip and pelvic muscles are not strong enough to support the increasing load, the surrounding muscles compensate and often spasm. These spasms can put extra pressure on the sciatic nerve, causing sciatic symptoms.
"Unlike muscles, you can’t stretch nerves. They’re like pieces of rope. When they’re tight in one place, you have to loosen them elsewhere to give the nerve mobility.”
Put simply, to get immediate sciatica pain relief during pregnancy, you’re going to have to loosen the nerve. From there, it’s important to strengthen the surrounding muscles. Strengthening the core, glutes, pelvic girdle, and pelvic floor helps your body make room and adjust to the increased load of pregnancy. For most women, physical therapy can help to stabilize the joints that have been loosened by pregnancy hormones. Sciatica pain relief will improve right away and increase within the first 7-14 days. If after 4 weeks the pain is not getting better, that’s a sign to re-evaluate the treatment plan.
The good news, sciatica during pregnancy is rarely forever. That said, moving your body consistently to prevent any flare-ups down the road is key.
Our team of expert physical therapists compiled 17 stretches and exercises that are safe for pregnancy and clinically proven to relieve sciatica pain from standing, sitting, in bed, or even lying on the floor.
Want to confirm your sciatica diagnosis? Or curious what’s actually causing your lower back pain? Book a free virtual evaluation with an Origin physical therapist.
Floor exercises for pain relief–but really, in-bed!
#1 Side-lying hip abduction
- Lie down on your side not affected by sciatica and extend the legs so the hips and feet are in a parallel line, one on top of the other.
- Bend your lower arm underneath your head, allowing the full weight of your head to rest on your forearm so it’s in line with your spine.
- Exhale while raising your upper leg to just above your hip joint. When you feel your hips and back start to tense, stop and hold the position for one to two seconds.
- Inhale and slowly lower your leg to its starting position, keeping it straight and stacked directly above the lower leg.
- Repeat for a total set of 10 raises and 2 sets per side.
#2 Figure 4 Stretch
- Lie on your back with your feet flat on the floor or bed.
- If your right side is affected, cross your right ankle over your left knee and keep your right foot flexed.
- Bring your left knee toward your chest. Reach your right hand through your legs and interlace your fingers just below the crease of your left knee - avoiding the knee joint.
- Pull your left knee toward your chest, pausing when you feel a stretch in your right glute and hip.
- Hold there for at least five breaths.
- Release and repeat as needed.
#3 Supine nerve glides
- Lay on your back and raise the affected side’s leg up.
- Hold the back of your leg above or below the knee joint and straighten the knee until you feel a gentle stretch.
- Move your ankle back and forth to feel a stretch in the back of your leg.
- Bend and extend the knee 10 times on each side. Do not perform more than 1 set per day or you may aggravate the nerve.
- Lie on your back with your knees bent and arms by your sides.
- Lift your torso such that your body is supported on your shoulders, arms, upper back and feet with your buttocks and lower back in the air.
- Hold for 1-2 seconds.
- Lower yourself slowly back down and repeat 10 times.
#5 TrA brace
- Lie on your back with your knees bent and your arms by your sides. If this is uncomfortable, you can also do this on all fours.
- Take a slow, deep breath in filling your belly with air. Try not to let your chest rise too much while you inhale.
- Slowly exhale. As you are pushing the air out of your lungs, draw your belly button up towards your spine tightening your lower abs.
- Hold for 2-3 seconds, and then inhale again repeating the exercise.
- Repeat 10 times.
- Start on all fours aligning your neck, shoulders, hips and knees.
- Inhale and contract your core as you tilt your pelvis back so that your tailbone and shoulders are angled toward the sky. Your belly will naturally get a few inches closer to the floor.
- Let this movement ripple from your tailbone up your spine so that your neck is the last thing to move. Imagine moving your spine vertebrae by vertebrae.
- Exhale as you slowly release your pelvis back into a neutral spine and allow the movement to flow into an arch, rounding your spine into the air.
- Again, let this movement ripple from your tailbone up your spine so that your neck is the last thing to move. Imagine moving your spine vertebrae by vertebrae.
- Perform 10 times.
Sitting stretches for immediate pain relief at work
#7 Seated pigeon stretch
- Sit on a chair with your feet flat on the ground.
- If your right side is affected, put your right ankle on your left knee.
- Keeping a straight back, lean forward until you feel a stretch through your buttocks.
- Hold for at least 30 seconds.
#8 Seated nerve glides
- Sit upright in a chair, with knees hip-width apart, feet flat on the floor and facing forwards.
- Extend the right leg, with the foot flexed toward the body.
- Extend the neck up and back to look up at the ceiling.
- Lower both the neck and leg down gently, so the chin tucks into the chest, and the leg goes slightly back past 90 degrees.
- Extend and lower the neck at the same time as extending and lowering the leg.
- Switch legs and repeat exercise 10 times for the left leg.
- Do 10 repetitions on both legs no more than one set per day.
- Sit on the edge of a chair with your feet directly underneath your knees.
- Lean forward a little so your nose extends just over your toes and use your legs to push up to a standing position. (Optional: You may use your arms to push off the chair or off of the knees if needed.)
- To sit, bend a little at the knees to push hips toward the chair and lower the body to a seated position.
- Repeat 10 times.
#10 Seated abdominal brace
- From a seated position, take a deep breath in and expand your rib cage.
- Tighten your core by pulling your rib cage down, as if you are about to be punched in the stomach.
- Hold for 10 seconds, then exhale.
- Repeat 10 times and perform 2-3 sets per day.
#11 Seated QL stretch
- While seated on a sturdy chair, if your right side is affected, slide to the right so that your right leg is relaxed and hanging straight off the edge of the chair.
- With your left arm, hold on to the left side of the chair for stability and raise your right arm above your head for a gentle side stretch.
- Let gravity relax your right hip.
- Hold for 60 seconds and repeat as needed.
Safe standing positions to relieve sciatica pain anywhere, anytime
#12 Standing hip abduction
- Standing tall while holding onto a sturdy object like a chair, raise the straight, affected leg out diagonally until you feel a gentle strain, about 3-4 inches off the floor.
- Hold for 3 seconds then return to the starting position.
- Repeat 10 times.
#13 Standing hip extension
- Standing by a counter or sturdy chair for support, tighten your core.
- Raise the affected leg slightly backward, keeping your knee straight until your foot is about 3 to 4 inches off the floor.
- Hold for 3 seconds, then slowly lower.
- Repeat 10 times.
#14 Standing pigeon
- Find a surface in your house that is about hip height. Slightly lower or slightly higher is okay, too. A countertop, a tall bed, or the back of a couch works great!
- Slowly lift your leg, bend your knee, and rotate your hip so that you can rest the outside of your lower leg fat on the surface.
- You should feel a stretch in the back of your hip. Lean forward to feel a deeper stretch.
- Hold for 60 seconds, and then switch legs. Repeat as needed.
- Standing with your fit hip-width apart, tighten your core.
- Bend your knees and slowly lower your hips backward until your hips are level with your knees.
- Pause for a moment.
- Press into your feet to slowly rise back to standing.
- Repeat 10 times.
#16 Ball to the glute
- Find a 2-3 foot stretch of wall without decorations or art.
- Take a lacrosse ball, tennis ball, or yoga tune-up ball and place it in the middle of your glute muscles - right in the middle of your buttocks.
- Lean into the wall so the ball is pressed into your glute.
- From here, move your hips side to side and up and down rolling the ball around your glute. If you want more pressure, lean in harder, if you want less pressure, back off a little. If you find a spot that feels really good, hang out there for 10-20 seconds.
- Perform for 60-90 seconds on each side. Repeat as needed.
#17 Quadratus lumborum stretch
- Standing your arm’s-distance away from a wall, gently extend your arm to the side and place one hand onto the wall.
- Cross the leg that is close to the wall in front of the other.
- Take your other arm and reach up and over toward the wall while gently pushing yourself away from the wall with the other arm stretching out your entire side.
- Hold for 30 seconds and then switch sides. Repeat as needed.
Still in pain? A few more ways to get some relief
Your third trimester of pregnancy is hard enough without dealing with sciatica pain. These functional stretches and gentle movements can help build on your body’s natural strength so you can sit, stand, and lay down, all without lower back pain.
Beyond physical therapy, additional tools for sciatica pain relief can take many forms, from hot-and-cold therapy, to pelvic support belts, to pain-relief patches, to sit-to-stand desks, lumbar pillows and more. There is no “one size fits all” approach to feeling better–do what works best for you!
Learn about chiropractic care for sciatic pain during pregnancy and whether it may be part of your treatment plan.