What should I ask my doctor to do about pregnancy leg pain?

June 27, 2016 11:10 AM

I have what is likely pregnancy-related sciatica. I also have an OB who is happy to refer me to any services or specialists I might desire. What should I ask for here?

I know that some of this is 'well, this is just part of pregnancy' territory. But I am quite uncomfortable and having trouble walking and performing routine activities around the house (such as getting baby's room ready) so if something can be done to improve things, I'd like it to be done. And the OB has so far been quite amenable to referring me to dietitians and dermatologists and so on, so if I say I want something for this, she'll do it. So...what do I want?

Backstory: I am 21 weeks. The pain started about two weeks ago as intermittent cramps in my right upper thigh. At a routine check-up, the nurse told me cramps were common and not to worry. Then last week, it settled in more permanently. It's fine when I'm sitting down, but if I walk too much, it starts aching. I then limp, which no doubt makes my posture and alignment even worse.

I took it easy yesterday, took off my Fitbit to stop obsessing about my activity levels and it felt much better. But at bedtime, husband innocently rubbed against the sore spot, and it was numb. It felt like that feeling of having been to the dentist when they froze your mouth and the freezing is starting to wear off. This morning, it was back to normal---until I did the dishes (on my feet again, obviously) and then it started aching.

At first, I thought it was not sciatica because the ache was more up the side of the thigh, not in front of it, and Dr. Google (I know, I know, I am not supposed to doing that!) said that was something else. But the numbness yesterday suggests it may be that after all. Or at any rate, this is one of those 'weight of the baby is compressing a nerve' things, and which particular nerve it is does not really matter.

I'm in Canada and my husband's work has generous benefits on top of that IF I have a prescription from a doctor that says I have to have it. And on that front, I have a very agreeable doctor who will refer me anywhere I want to go. My concerns are that I know keeping active is good for the baby (hence, my purchase of a Fitbit) so if something can be done to keep this activity possible, I'd like to. And I don't really want to make the normal aches and pains of pregnancy worse by ruining my posture with five more months of limping around. So, chiropractor? Massage service? What should I ask for here?

posted by JoannaC to Health & Fitness (17 answers total)

Best answer: Physical therapy. Let them help you learn how to least aggravate it, what kind of exercise is most helpful, and stretches/sleep positions/etc you can use as well. They may additionally prescribe massage (and/or hydrotherapy, which is also nice!), but it will be a specific sort, and you want to look to them for guidance on how/where/who.
posted by Lyn Never at 11:14 AM on June 27, 2016 [4 favorites]

Pregnancy puts you at increased risk of blood clot, also. If you are having leg pain with numbness, I would honestly go to the ER. They can do an ultrasound of your leg and rule out a blood clot immediately. A blood clot is super serious business and if there's a chance you have one you should not mess around with that. If you're in Toronto go to either Toronto General (thrombosis/embolism clinic) or Mt. Sinai (special pregnancy program that includes hematologists specializing in pregnancy stuff). If you go to those ERs you could get into those clinics quickly afterwards if you need to.
posted by If only I had a penguin... at 11:15 AM on June 27, 2016 [2 favorites]

Oh, and blood clots are worse when you stand/walk better when you sit/lie down (in terms of symptoms).
posted by If only I had a penguin... at 11:16 AM on June 27, 2016

I wonder if a TENS unit would help. That's one drugfree possibility.
posted by fiercecupcake at 11:28 AM on June 27, 2016

Seconding the concern about blood clots. My partner is now permanently (mildly) disabled and could easily have died from a blood clot resulting from a broken knee. She has a genetic predisposition for clotting that anyone could have without realizing it.

Not to be overly paranoid, but it's a serious thing that should be ruled out ASAP.
posted by klanawa at 11:28 AM on June 27, 2016

2nding PT/massage. Sciatic pain is often caused by a tight piriformis. I still get very occasional zings of it 2 decades after my pregnancy. Five minutes of an elbow in the glutes straightens me right up again, and if I did the recommended stretches I probably wouldn't even need that.
posted by headnsouth at 11:30 AM on June 27, 2016 [2 favorites]

Can you get to a pool for a bit of a float? The baby may be resting on a nerve. You can drink mineral water to help with cramps. Buy a body pillow or put a regular pillow between your knees when you sleep to help keep your spine in line. And yes, tell your doctor.
posted by myselfasme at 12:25 PM on June 27, 2016 [2 favorites]

If it is sciatica, I had great success with a talented massage therapist who dug her elbow (?) into my buttcheek, bent my leg at the knee, and maneuvered my leg around while massaging that spot and lo! I was cured! I couldn't believe it! I recommend massage.
posted by meggan at 12:47 PM on June 27, 2016 [1 favorite]

All of the above, plus yoga may help.
posted by vunder at 2:39 PM on June 27, 2016

Oh boy, I was the pregnancy sciatic pain expert. My pain was so bad that when I walked it would be like lightning shooting through my leg which would make my leg collapse under me, then I would hit the ground. At nine months pregnant. Fun times. The only thing that worked for me was seeing a physio and getting massages. And when I say 'worked for me' it was a temporary allievement of the pain. I was told there was no real cure while the pregnancy hormones were in my body, relaxing all my muscles and prepping me for birth. It also continued while I breastfed. I hope your situation is less dramatic than mine, but see a physio. And hugs, I remember well how miserable I was. Just focus on the baby at the end of it all.
posted by Jubey at 3:15 PM on June 27, 2016

Physical therapy was good for me but warm water pool therapy was EVEN BETTER! Basically twice a week I went to a warm-water therapy pool and a pool therapist led me through a series of gentle exercises moving my leg and back in different ways, which helped loosen and strengthen everything in my leg and low back. But the warmth of the water relaxing my back muscles and the buoyancy of the water lifting the baby off my spine for an hour helped at LEAST as much as the exercises.

Physical therapy and massage (from a physical therapist experienced in pregnancy massage) were also helpful and I recommend them (especially as therapy pools can be hard to find!), but the warm water pool helped the most.

(A warm water therapy pool is around 92*F and safe for baby; it's not over 100 like a hot tub that's unsafe.)
posted by Eyebrows McGee at 4:46 PM on June 27, 2016

These stretches helped me a bunch. Good luck!
posted by CatastropheWaitress at 5:28 PM on June 27, 2016 [1 favorite]

See if you can get in to see a massage therapist. Helped me a lot!
posted by Toddles at 7:44 PM on June 27, 2016

I am having a lot of back pain, and in addition to exercises to strengthen my outer thighs and core, my PT recommended an SI joint belt--you can find them on Amazon. No idea if this would help you at all, but I find it comfortable.
posted by bookworm4125 at 8:32 PM on June 27, 2016

Everybody is different, but FWIW my pregnancy leg pain was random shooting pains that made me nearly fall over, or sudden less intense but predictable terrible joint pain when I did things like put on underwear or try to get out of bed. I never had anything that I'd describe as an ache with numbness. Also FWIW, my friend just had a baby and she had issues more like yours; she was diagnosed with blood clots postpartum and her doctor is annoyed that her obgyn didn't catch the symptoms and refer her earlier so she could be put on blood thinners.
posted by gatorae at 9:01 PM on June 27, 2016

Best answer: IANYD but am an OB in training.

If it's really more like cramps then you can try magnesium oxide supplements and increase your hydration throughout the day.

It's highly unlikely to be a blood clot in that location.

Much more likely nerve compression (sciatic nerve being the most common and well-known, but others can be compressed in pregnancy leading to weird shooting and zinging pains). Nthing PT, stretches, and massages. Often a pregnancy belt can be helpful in this situation as well. If you can't stand to wear it during the day some of my patients have luck sleeping in it (the principal being like a retainer--wearing it a few hours can be helpful for several hours thereafter).
posted by eglenner at 1:09 AM on June 28, 2016

I also was going to suggest it could be your sacro-iliac joint. Sounds very similar to symptoms I have/had that started with pregnancy. I'm not sure if it helps that much to have more ideas to consider for what it is, but I would suggest that as an option.
posted by freezer cake at 2:20 PM on June 28, 2016