Sciatica in special cases (pregnancy, children, elderly)

Sciatica can occur in pregnancy, in children and teenagers, and in older adults. The causes and safe treatments differ in each group.

Pregnancy

• Sciatica or sciatica-like pain is common, often in the third trimester, due to the weight of the baby, a changed posture and the hormone relaxin loosening ligaments. Pelvic girdle pain can mimic it.
• Safe measures: gentle walking, swimming, prenatal yoga, a pregnancy support belt, a pillow between the knees at night, warm compresses and physiotherapy.
• Paracetamol is generally preferred for pain. Avoid NSAIDs unless a doctor agrees, and do not use herbal products or strong oil massage over the belly.
• Pain usually improves after delivery. Seek urgent care for leg weakness, loss of bladder or bowel control, fever or severe pain.

Children and teenagers

• Sciatica is uncommon. Causes include a disc herniation after injury or heavy sport, a stress fracture of the spine (spondylolysis), tight hamstrings or, rarely, infection or a tumour.
• Persistent back or leg pain, night pain, fever, weight loss or weakness in a child needs a doctor's review.
• Treatment is usually activity changes, physiotherapy and simple pain relief. Do not give adult medicines or herbal remedies without advice.

Older adults

• Spinal stenosis and degenerative changes are the commonest causes. Pain often worsens with walking and eases on sitting or leaning forward.