Clinically reviewed by What is sciatica pain in pregnancy
Sciatica in pregnancy is pain that starts in the lower back or buttock and travels down one leg. The sciatic nerve runs that path, and in pregnancy everything around it carries more load than usual.
Most people describe it as hamal mein kamar se taang tak dard. True sciatica, where a disc presses on a nerve root, is less common in pregnancy than people assume. Far more often the pain comes from the pelvic joints or the deep buttock muscles and only feels like nerve pain.
That difference matters, because the two are treated differently.
Symptoms you might have
- Pain from the lower back or buttock down the back of one leg
- Usually one side only, and often the side you sleep on
- Sharp or burning pain rather than a steady ache
- Pins and needles or numbness in the leg or foot
- Worse on turning over in bed, standing up from a low chair and climbing stairs
- Pain over the pubic bone, or clicking in the pelvis, points to pelvic girdle pain rather than the sciatic nerve
Why it happens
- The weight of the growing baby and the forward shift in your balance, which increases the curve in the lower back
- Pregnancy hormones that soften the pelvic ligaments, so the joints move more and the muscles work harder
- Deep buttock muscles going into spasm and irritating the nerve as it passes under them
- A back that was already weak or painful before pregnancy
- Long hours standing to cook, or squatting to wash and clean floors
- Sitting on soft beds and low sofas with no back support
- A disc problem, which happens in pregnancy but is the less common cause
When you should see a physiotherapist
Come in when the pain is interfering with sleeping, walking or standing, or when it travels below the knee. You do not have to accept it as part of pregnancy.
Tell us how many weeks pregnant you are at first contact. Get your doctor's clearance before starting any exercise programme, especially if the pregnancy is high risk or you have been told to rest.
Go to a hospital the same day if you have numbness around the groin or back passage, if you cannot control your bladder or bowels, or if both legs feel weak.
Go immediately if you have vaginal bleeding, fluid leaking, tightening pains coming in waves, reduced movements from the baby, or fever with back pain.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Treatment is adapted for pregnancy from the first appointment. Positions are changed so you are not lying flat on your back, and the assessment works out whether the pain is coming from the nerve, the pelvic joints or the buttock muscles.
- Manual therapy to the lower back, pelvis and hips, done in side lying or sitting, to restore movement and settle the muscles
- Exercise therapy, gentle pelvic tilts, deep abdominal and pelvic floor work and hip strengthening, which is the part that holds the improvement
- Nerve gliding for the sciatic nerve, done slowly and never into numbness
- Soft tissue work for the buttock and hip muscles, which are often the real source
- A pelvic support belt where the pelvic joints are involved
- Practical changes to sleeping, sitting, standing and getting in and out of bed
Electrotherapy, ultrasound, TENS and dry needling are not used over the abdomen, lower back or pelvis during pregnancy, and hijama is not done during pregnancy at all. Pregnancy related sciatica is not a surgical problem.
Exercises, and what to avoid
What helps
- Pelvic tilts on all fours or sitting on a firm chair, small and slow, repeated ten times
- Side lying hip lifts and clams for the buttock muscles, both sides
- Pelvic floor squeezes, a few times a day, which support the whole area
- Walking on flat ground, short and often, several times a day rather than one long walk
- Walking in water, if you have access to a safe pool
What to avoid
- Lying flat on your back for exercises after about the fourth month
- Deep squats, and anything that pulls the legs far apart, because that stresses the pelvic joints
- Hard hamstring stretching. It feels tight but it is an irritated nerve, and stretching aggravates it
- Sit ups, crunches and twisting exercises
What you can do at home
Sleep on your side with a pillow between your knees and a pillow under the bump. After about the fourth month, avoid lying flat on your back for long periods.
Roll, do not twist, when getting out of bed. Bend your knees, roll onto your side, then push up with your arms.
Sit with your back supported and both feet flat on the floor, with a cushion in the small of your back. Get up and move every 20 to 30 minutes. Stop sitting cross legged on the floor while this is settling.
A warm pack for 15 to 20 minutes on the buttock or the side of the hip is safe and usually helps. Never put heat on your abdomen, and never hot enough to redden the skin.
How long it takes
Most women notice a real difference within two to three weeks of starting treatment, and many are managing comfortably within six weeks.
The pain will not disappear completely while you are pregnant, because the load causing it is still there and still increasing. The aim is to keep you sleeping, walking and working.
After delivery, most pregnancy related back and leg pain settles within three to six months, as the weight comes off and the ligaments firm up. Our page on back pain after delivery covers that stage.
What slows it down is long hours sitting or standing, and leaving it until the last weeks before getting help.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
حمل کے دوران کمر سے ٹانگ تک درد عام ہے۔ بچے کا وزن بڑھنے سے کمر پر بوجھ بڑھتا ہے اور پیڑو کے جوڑ ڈھیلے ہو جاتے ہیں۔
ضروری نہیں کہ یہ ڈسک کا مسئلہ ہو۔ اکثر درد پیڑو کے جوڑوں یا کولہے کے گوشت سے آتا ہے۔
کروٹ لے کر سوئیں، گھٹنوں کے درمیان تکیہ رکھیں۔ چوتھے مہینے کے بعد سیدھا کمر کے بل لمبا وقت نہ لیٹیں۔
حمل میں پیٹ، کمر یا پیڑو پر الیکٹروتھراپی، الٹراساؤنڈ، ٹینس اور ڈرائی نیڈلنگ نہیں کی جاتی۔ حجامہ بھی حمل میں نہیں کرتے۔
ورزش شروع کرنے سے پہلے ڈاکٹر سے اجازت لیں۔ اگر خون آئے، پانی جائے، بچے کی حرکت کم ہو، یا پیشاب پاخانے پر کنٹرول ختم ہو جائے تو فوراً ہسپتال جائیں۔
Roman Urdu
Hamal ke doran kamar se taang tak dard aam hai. Bachay ka wazan barhne se kamar par bojh barhta hai aur pelvis ke jorh dheele ho jate hain.
Zaroori nahi ke ye disc ka masla ho. Aksar dard pelvis ke jorhon ya kolhe ke gosht se aata hai.
Karwat le kar soyen, ghutnon ke darmiyan takiya rakhen. Chauthe mahine ke baad seedha kamar ke bal lamba waqt na leten.
Hamal mein pet, kamar ya pelvis par electrotherapy, ultrasound, TENS aur dry needling nahi ki jati. Hijama bhi hamal mein nahi karte.
Warzish shuru karne se pehle doctor se ijazat len. Agar khoon aaye, pani jaye, bachay ki harkat kam ho, ya peshab pakhane par control khatam ho jaye to foran hospital jayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Is physiotherapy safe during pregnancy?
Will sciatica harm my baby?
Is it sciatica or pelvic girdle pain?
Which side should I sleep on?
Does pregnancy sciatica go away after delivery?
Related conditions
- Pelvic floor weakness and exercises
- Back pain in pregnancy
- Diastasis recti treatment
- Lower back pain in women
- Recovery after a C-section