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Back or Sciatic Pain in Pregnancy

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by Elise Bowerman

About 50-80 percent of women experience low back pain during pregnancy. It is SO common!

Please note: this is not an exhaustive article. There’s plenty of wonderful books and online advice to help you alleviate and/or avoid this experience. Below are my top recommendations when you’re having low back or sciatic pain or are unsure what’s happening, or if you have discomfort in the pelvis.

The pelvis is in the shape of a bowl. When the bowl shifts (often thanks to baby) then that's when discomfort comes to play.

Permission to use copyright image from Pelvic Guru, LLC

Sometimes it is difficult for your healthcare provider to pinpoint a solid diagnosis to your discomfort; besides constipation, UTI's, excessive standing/sitting and general postural alignment. This is due to at least two other possible causes:

  1. Lumbro/Sacral herniated discs: often L4/L5/S1 vertebrae pinching the nerves
  2. Periformis syndrome: the periformis muscle can surround the nerve. When overused will spasm resulting in pressure on the sciatic nerve. (see picture below)

Permission to use copyright image from Pelvic Guru, LLC

Since the two reasons listed above are musculoskeletal, I highly recommend three options to gather information to alleviate pain:

  1. Pelvic Floor Physical Therapy: get a prescription from your PCP, OB/GYN, or midwife. This therapy may be covered under insurance. There are also independent practices you can contact.
  2. Chiropractic Care: some insurances will accept chiropractic care. 
  3. Osteopathic Manipulative Treatment: get a prescription from your PCP, OB/GYN or midwife. This therapy will likely be covered under insurance. 
  4. Massage Therapy: this is usually an out of pocket investment. If a massage therapist works within any of the above practices, then check to see if receiving a referral will then be covered by insurance.

Contact your insurance company first. Otherwise pay out of pocket, or use HSA/FSA from an employer. Investing in your (and your baby's) health is worth it.

What to do in a Prenatal Yoga Class

First, tell your teacher. We need to know what's going on so you can benefit most from your practice.

When you are experiencing inflammation (hot, dull or shooting pain) be extremely gentle on that area. This is counter-intuitive: do not knead, press or emphasize this area as it may cause more inflammation. 

Focus on your posture. Align bone on bone; muscle on muscle.

Postures to explore: Cat/Cow, Tadasana and Samasthiti.

Move slowly with great awareness of posture, breath and ease in movements.

Avoid deep hip openers like pigeon pose and fire log pose. Once you feel the sensation of inflammation (sometimes it can feel like stretching at first)  stop there. Go no further.

When something doesn't feel right. Then it isn't right. Rest for a minute - or do something else - then pick back up with the class when it feels right again.

Always consult your health care provider. Trust your instincts.