Ah, the joys of pregnancy! Whether this is your first or fifth baby, there is much to look forward to and prepare for. Unfortunately, the excitement of becoming a mother can be overshadowed by back pain and sciatica. Three out of 4 pregnant women experience back pain—some long before they lose their waist! To help you prevent or ease back pain caused by sciatica, we provide answers to why symptoms often develop and what you can do to make the months ahead easier.

How Does Pregnancy Cause Back Pain and Sciatica?
The changes to your body throughout pregnancy affect more than physical appearance, as you're well aware.

1. Familiar to most women is weight gain—25 or more pounds. The increase in body weight and stress when bending puts pressure on a bulging or herniated disc in the low back. Back and leg pain (eg, sciatica, which is also called lumbar radiculopathy) are common complaints.
2. Weight gain may cause piriformis syndrome and sciatica. The piriformis muscles (located in the buttocks) assist thigh movement. Piriformis syndrome can develop when the muscle compresses the sciatica nerve, which passes through the buttock into the thigh.
3. What might not be immediately obvious is—as the uterus grows larger (and larger!), the body's center of gravity is thrown off. Sometimes, as the uterus expands within the pelvis, the spinal nerves in the lumbar and sacral spine (low back) that feed into the sciatic nerve become compressed and irritated. This is another cause of back pain and sciatica.
4. Plus, hormones are at work. In particular is relaxin, a hormone that relaxes pelvic ligaments and helps to ready the mother's body for birth. Relaxin also loosens ligaments in other parts of the body, but mostly the joints in the pelvis, low back, and knees. This is important to know when exercising or lifting objects because it is easy to strain yourself during pregnancy. Move slowly, and avoid sudden movements.

What to Do

1. Work with your doctor, chiropractor, midwife, or health care provider to keep body weight in check.
2. If back pain develops, talk to your doctor, chiropractor, midwife, or health care provider.
3. Pay attention to your posture! Stand up straight, shoulders back, buttocks tucked under, and avoid leaning backward.
4. Try a pillow—such as a standard-sized pillow or body pillow to help make sleeping comfortable. A pillow can be positioned between the knees and under the abdomen for support.
5. Prenatal yoga helps stretch and tone muscles, helps you maintain flexibility, improves balance and circulation, and relieves tension. Deep breathing is a huge part of yoga and an added benefit for mothers-to-be. Learning how to breathe deeply and relax can help during labor, too. Combined with simple cardiovascular exercise such as walking and/or swimming, these activities can help keep your weight under control and body in shape. Ask your doctor or health care provider if these exercises are right for you!
6. Prenatal massage may help relieve pain and tension. Massage therapists trained in prenatal massage can be a pain relief resource during pregnancy and labor. This type of massage eases anxiety (helps to stabilize hormone levels), back pain, pelvic and hip pain, improves circulation and digestion, and helps reduce fatigue.
7. A warm shower or bath helps ease back pain. However, expectant mothers should avoid certain aromatic oils (aromatherapy, candles) such as basil, juniper, peppermint, rosemary, and star anise. Some oils can cause contractions.
8. Acupuncture is an alternative therapy to treat back pain and sciatica. Sterile, hair-thin disposable needles are inserted into points on the body called meridians; energy channels. It is theorized the needles work to free the flow of qi (pronounced chee) to help the body heal.

Ergonomic Pointers: At-work, Home, and Leisure Time
Expectant mothers should avoid awkward postures, extreme forces such as heavy lifting, and repetitive tasks—especially during the third trimester. Late in pregnancy, a woman's body is at its most challenging—ergonomically speaking. 

1. The muscles of the low back and legs work harder to maintain balance. Simple standing or walking can be a challenge. Extremity swelling is common. Frequent breaks and resting (elevating the feet) is helpful.
2. An ergonomically designed and adjustable chair with supporting lumbar back rest and foot rest can make desk work more comfortable. Change posture often by frequently sitting and standing.
3. If the task requires sitting, take periodic breaks to walk. Walking helps reduce swelling by increasing circulation.

Hopefully, you will be one of the few expectant mothers whose pregnancy progresses free of back pain or sciatica. Remember—if back pain and/or sciatica starts, talk to your doctor, chiropractor, midwife, or health care professional first.