Sciatica and pregnancy - an osteopathic perspective

Osteopaths are not strangers to patients suffering with sciatica, however, when the patient suffering is pregnant a new set of conditions arise that may affect the sciatic nerve that need to be considered. The most obvious change affecting a pregnant woman is the increase in the size of the uterus.  As it expands the hip, pelvis and low back all have to adjust their position relative to one another in order to accommodate the increase in weight. This affects all the surrounding soft tissues. Since the sciatic nerve exits the lumber spine, enters the pelvis and continues its journey to the hip joint and into the  leg it is not surprising that osteopaths see pregnant women suffering with sciatica.  

The spinal cord and nerve roots are flexible neurological soft tissues and are normally able to stretch and curve around the bony structures of the spine and pelvis.  However, during the last 3 months of pregnancy as weight increases anteriorly for the pregnant woman, the lumber spine is pulled into extension narrowing the intervertebral foramen of the lumber spine and reducing the aperture through which the nerve roots of the sciatic nerve pass. Anyone who has a degree of stress through the sciatic nerve roots to begin with could start to feel leg pain as the pressure on the sciatic nerve increases. 

The glutei muscles are strong postural muscles that attach from the hips to the pelvis and sacrum. One of their functions is to keep the body upright, therefore as the center of gravity shifts anteriorly during pregnancy their workload increases and thus their tone. The sciatic nerve traverses the glutei muscles making it vulnerable to compression as it passes through the glutei muscles.  Once the hypertonia in the glutei muscles reaches a point where it compresses the sciatic nerve, there is hypoxia in the nerve and the pregnant patient may start to experience sciatic pain in the leg.

It is up to the osteopath to find out where along the path of the sciatic nerve, from the back to the leg, the sciatic nerve it is being compressed.  With some conservative osteopathic techniques the osteopath can take the stress off the spine, pelvis and surrounding muscles. The aim of the osteopath is to integrate the function of the muscles of the pelvis, hips and spine to encourage the body to make the transition smoothly.

The osteopathic treatment should be to allow the spine to shift according to changes in the center of gravity thus spreading out the weight equally and efficiently.  Furthermore the osteopath should aim to help the the hips and pelvis to anteriorly and posteriorly rotate dynamically and according to the changes in weight-bearing.

For more information:

http://www.osteopath.co.il/pregnancy-related-pain-heb.php

http://www.osteopath.co.il/pregnancy-related-pain.php

Danny Sher B.Sc (Hons) Ost. Is a registered osteopath in the UK and Israel.

He works in his clinics in Jerusalem and Modiin.

www.osteopath.co.il

Danny Sher

Registered osteopath

Jerusalem: 14 Kaf Tet b'November Street

Modiin: Dimri Medical Center, 37 Yigal Yadin Street

02-561-1808

0522606774

www.osteopath.co.il

Www.osteopath.co.il