How to Sleep With Lower Back Pain and Sciatica

If you’re among the 40% of people who develop sciatica, you know that it can be debilitating – especially at bedtime. But, sleep is an essential part of the body’s restorative process and necessary for healing. If sciatica is keeping you up at night, it can create a vicious cycle that ultimately slows your recovery. 

Rest assured, it’s possible to sleep soundly with sciatica. Keep reading for our complete run-down on how to sleep with lower back pain and sciatica.

How to Sleep With Lower Back Pain and Sciatica

Table of Contents

What Makes Sciatica Worse at Night?

Lying down for several hours makes sciatica worse at night. 

When you lie down, pressure on the sciatica nerve and lumbar nerve roots increases. Certain sleeping positions can exacerbate this issue, including stomach sleeping. 

Lying on your stomach forces your spine out of its natural curvature, placing more stress on the lumbar spine. Your spine curves toward the mattress, creating an extension that can worsen lower back pain. Sleeping on a soft mattress can exacerbate this issue by making you sink deeper into the extension. 

Additionally, any sleeping position that twists the spine or hips can make sciatica worse at night. Twisting increases pressure on the sciatic nerve, leading to more pain and inflammation. 

How Should You Sleep with Sciatica?

With sciatica, it’s best to sleep in one of the following positions:

  • Side sleeping with a pillow between your knees is one of the best sleeping positions for sciatica. The pillow helps keep the pelvis and spine in a neutral alignment. It can also prevent twisting while you sleep. 
  • Back sleeping with a pillow under your knees is another position that alleviates pressure on the sciatic nerve. Sleeping on your back keeps your weight distributed evenly, while the pillow keeps the spine in a natural, comfortable alignment. 
  • Back sleeping with a thin pillow under the lumbar spine is a good option if there’s space between your back and the mattress when you lie on your back. The pillow will keep your pelvis neutral and prevent stress on the sciatic nerve while you sleep. 
  • Fetal position may work for some people with sciatica from a lumbar herniated disc. With your body in a “C” position on your side, there’s more space between each of the vertebrae in the spine. However, if this position worsens your pain, opt for one of the other options listed above. 

Some people find that sleeping on a flat surface, like the ground, offers the best relief from sciatica pain. Flat surfaces may keep the spine in better alignment than mattresses. You may also benefit from a firmer mattress that doesn’t allow your body to sink. 

Is It Better to Rest Sciatica or Keep Moving?

It’s better to keep moving with sciatica, with short periods of rest. Just stick to low-impact exercise and if it hurts, take a break. 

Low-impact exercise like walking, swimming, and water aerobics benefits sciatica by:

  • Improving circulation throughout the body
  • Strengthening muscles that protect the spine
  • Boosting mobility and flexibility 
  • Promoting the release of endorphins, brain chemicals with natural pain-relieving properties 

While you should take breaks and rest as needed, don’t remain sitting or lying down for too long. Prolonged periods of bed rest can worsen sciatica by reducing blood flow to the back, worsening muscle tension, and even contributing to muscle atrophy. 

How Do I Get My Sciatic Nerve to Stop Hurting Fast?

You can get your sciatic nerve to stop hurting fast with gentle stretches, heat/cold therapy, and over-the-counter pain medications. 

  • Gentle stretches help with sciatica by relaxing the back muscles and boosting blood flow to the back. Tight muscles can increase pressure on the sciatic nerve, making stretching an important part of your wellness routine. Recommended stretches include:
    • Figure-4 stretch
    • Standing hamstring stretch
    • Pigeon pose
    • Scissor stretch
    • Knee-to-chest stretch
Sciatic Nerve to Stop Hurting Fast
  • Heat and cold therapy offer myriad benefits for sciatica. An ice pack can bring down inflammation and lessen pain in the lower back. A heating pad can relax the affected muscles and reduce muscle spasms. 
  • Over-the-counter pain medications, like ibuprofen, can provide fast relief from sciatica pain. While not a long-term solution, these medications can benefit a well-rounded sciatica treatment plan. 

While these remedies can offer quick relief, they may not be enough to fully resolve your sciatica. Physical therapy, chiropractic care, massage therapy, acupuncture, and doctor-recommended lifestyle changes may provide further relief. 

What Is the Most Effective Pain Relief for Sciatica?

The most effective pain relief for sciatica is medications, including muscle relaxers and painkillers, and physical therapy. 

Medications can alleviate sciatica pain by blocking pain signals, reducing inflammation, or preventing muscle spasms, depending on the specific medication. Your physician may suggest over-the-counter medications or prescription options for more severe cases. 

Sciatica Treatment Options

Sciatica treatment options include heat/cold therapy, physical therapy, chiropractic care, massage therapy, acupuncture, medications, steroid injections, and surgery. 

  • Physical therapy for sciatica involves targeted exercises, stretches, and manual therapies to reduce pressure on the sciatic nerve. Your PT will work with you to implement better posture and body mechanics to help the sciatic nerve heal. 
  • Chiropractic care involves manual adjustments, non-surgical spinal decompression, and complementary therapies to restore spinal alignment. It can help decompress the sciatic nerve and improve the body’s healing process. 
  • Massage therapy can help with sciatica by reducing muscle tension, preventing muscle spasms, and boosting circulation to the affected area. 
  • Acupuncture involves inserting small needles into specific points on the body to release tension and improve the body’s healing capacity. It can help alleviate sciatica pain. 
  • Steroid injections significantly reduce inflammation at the injection site, providing pain relief. While they must be used sparingly to prevent tissue atrophy, steroid injections may be used to manage sciatica pain. 

Surgery is generally only recommended in severe cases of sciatica that don’t respond to conservative treatment. Surgery for sciatica may include microdiscectomy or laminectomy, depending on the cause of the impingement.

Regain your mobility with Premia Spine!

David danced at his son’s wedding

Bonnie explains why TOPS surgery was the right decision for her

Wade is back to hiking

Scott speaks about going to surgery

Regain your mobility with Premia Spine! Contact us now

How to Live with Sciatica

To live with sciatica, maintain a gentle exercise routine, use heat and ice therapy to manage pain, use sciatica-friendly sleep positions, and try to stay as active as possible. 

Remaining active is crucial to living with sciatica, as immobility can worsen muscle tension and even cause muscle atrophy. Engaging in your regular activities can also preserve your quality of life as you manage sciatica. But, make sure to avoid any exercises or activities that your doctor advises against. 

Other lifestyle tips that can help you live more comfortably with sciatica include:

  • Quit smoking, as smoking can compromise your overall spinal health.
  • Reach a healthy weight, as excess weight imparts additional stress on the sciatic nerve.
  • Use orthopedic inserts in your shoes and avoid unsupportive footwear, like high heels.
  • Practice good posture and avoid long periods of sitting.
  • Make sure your back pockets are empty before sitting down.
  • Invest in a firmer mattress.

If your sciatica persists despite at-home treatment, reach out to your physician for an evaluation.