Some lucky women breeze through pregnancy with hardly any physical discomfort. But for others, unexpected aches and pains become a constant part of the nine-month journey. One of the most common complaints massage therapists hear relates to sciatica pain. Fortunately, one of the most effective treatments for this issue is massage.
The sciatic nerve runs from the neck through the midsection of the back of the body and into the leg. As a woman’s pregnancy advances, this nerve bears the brunt of the growing fetus and expanding uterus. Additionally, swelling from water retention can increase pressure on this nerve, contributing to inflammation. Pregnant women who drive long distances or have jobs that require sitting for long periods of time may have a higher risk of developing sciatica. And, of course, the position of the fetus significantly affects sciatic-related pain.
Sciatic pain typically affects only one side of the lower body and may extend from the lower back into the back of the thigh and down the leg. In some cases, the pain may also radiate into the foot or toes. As the fetus moves, the pain may subside or worsen. Unfortunately, sciatica is fairly common during the second and third trimesters.
However, each woman has a different pain threshold and will experience different symptoms. In some cases, sciatic pain can be quite severe and debilitating. In others, the pain could be fleeting and mildly discomfiting. Some women report a pinprick sensation in the leg, foot or lower back. Others experience mild numbness and tingling, a dull ache or burning sensation. In extreme cases, the pain can be incapacitating. Sciatic pain is unpredictable and could resolve on its own. But if your client has tried rest and other options, such as cold compresses, without any relief, you should educate her about the benefits of massage for her pain.
Before beginning massage, you need to identify the severity and point of origin of the pain. Judy Koch of the Institute of Somatic Therapy begins with an assessment of the area between the sacrum and greater trochanter followed by gentle stretches. Bending the knee and lifting the foot will help to lengthen the piriformis muscle. Note that clients should be in a side-lying position. You can warm up the area with a series of passes using your fist, forearm or elbow. Koch also recommends static compression with the elbow or a loose fist. Constant pressure on the piriformis and gluteal muscles helps them relax and reduces spasms. If you do deep tissue massage, be sure to direct movements toward the inguinal ligaments.
Pain associated with sciatica may continue after the baby is born, since the rate at which the uterus returns to its normal size varies from one woman to the next. So regular massage post delivery can help relieve discomfort and allow the new mom to enjoy her infant. But you can assure your client that, unless a sciatica injury was present before she became pregnant, the pain will eventually go away.