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How to Sleep With Sciatica: Tips, Tricks, and Techniques

Sciatica pain affects between 10% and 40% of adults. Despite how common this condition is, there are many myths and misconceptions surrounding the cause, treatment, and options for living with this, sometimes debilitating, pain.

Over 55% of patients who suffer from chronic back pain also have trouble sleeping. The inability to find a comfortable sleep position, frequent awakenings, and persistent discomfort can all make it impossible to fall and stay asleep.

If sciatica pain is keeping you up at night, keep reading. In this article, we’ll offer tips and tricks for achieving a quality night’s sleep despite having sciatica pain. Plus, more information on what causes this lower back discomfort and techniques for easing sciatica pain even before climbing into bed at night.

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Sciatica Pain: Causes, Symptoms, and Risk Factors

Before we discuss how to sleep with sciatica pain, let’s briefly go over exactly what it is. Sciatica is the term used to describe the pain people feel when their sciatic nerve becomes inflamed or compressed due to spinal abnormalities.

The sciatic nerve runs from your lower back down through your hips and buttocks. From there, it extends down both legs. Most instances of sciatic pain are triggered by an overgrown bone or a herniated disk that puts extreme pressure on this nerve. In addition to pressure, these abnormalities also cause inflammation, pain, and in some cases, numbness. Because the sciatic nerve extends from the lower back down both legs, many people describe sciatica pain as “shooting” or a dull ache that causes tingling and loss of feeling in one or both legs. You may notice muscle weakness in one or both legs during a flare-up.

For some people, this pain becomes worse or more intense when lying down, increasing pressure on the lower back and sciatic nerve. This is especially common in individuals who sleep on a soft mattress which may cause the spine to bend even further. A firm mattress offers more support and stability.

The physical pain caused by pressure on the sciatic nerve is just one trigger for insomnia and disrupted sleep. Many people with sciatica pain also experience anxiety leading up to bedtime. This can include anxiety over feeling even more pain when lying down and anxiety over the inability to fall asleep. This combination of anxiety before bed and chronic pain can make it increasingly difficult to achieve quality sleep, worsening both your physical and mental state.

Several things can cause sciatica pain or trigger a sciatica flare-up, including:

  • Muscle spasms (usually in the lower back or buttocks)
  • Tight or strained muscles 
  • Spondylolisthesis (occurs when one vertebra slips over another)
  • Degenerative disc diseases (the breakdown of the discs that cushion the vertebrae) 
  • Pregnancy
  • Spinal stenosis (the narrowing of the spinal canal)
  • Obesity
  • Wearing unsupportive shoes for an extended period of time
  • Lack of exercise
  • Sleeping on a mattress that’s too soft or not supportive enough 
  • Bone spurs

Sciatica pain isn’t always constant but flare-ups can last up to 4 to 6 weeks or longer, depending on the cause. In rare cases, sciatic pain is caused by an abnormal growth or tumor in the area of the sciatic nerve.

Tips for Sleeping with Sciatica Pain

If the above-mentioned symptoms describe you or you’ve been suffering from an increase in sciatica pain that’s also affecting your sleep, keep reading. Here are several helpful tips and tricks for easing sciatica pain at night and finally achieving the quality sleep you need.

Upgrade Your Mattress

While a soft mattress may not be causing your sciatica pin, it’s certainly not helping. The first step in easing your discomfort is upgrading your mattress to one that’s more supportive. Firm and semi-firm mattresses can offer the spinal support you need to relieve pressure on this sensitive nerve.

Memory foam and plush mattresses that are often too soft don’t offer adequate resistance against your body weight. They conform and shape to your body, cradling it rather than supporting it. If possible, invest in an orthopedic bed designed to ease back pain, including sciatica.

Your sleep position can dictate the type of mattress you need. For example, stomach sleepers need a firm mattress that keeps their body lifted. (Although, as we’ll explore later, individuals with sciatica pain should avoid sleeping on their stomachs.) Side sleepers can use a slightly softer mattress that delivers support near both the hips and shoulders. Back sleepers will see the best results from a medium-firm mattress that provides full-body support. 

Invest in a Body Pillow or Neck Pillow

The type of mattress you sleep on isn’t the only bedding product that matters. The right pillow can do wonders for your sciatica pain. Let’s start at the top by finding the right pillow for your head. Despite how comfortable soft, fluffy pillows might seem, they offer little support. An unsupported neck can cause increased strain and tightness in the shoulders that lead down to the back and, eventually, the sciatic nerve. It’s important to keep your cervical spine aligned to reduce back pain and sciatica flare-ups. Choose a neck pillow that’s supportive, firm, and of high quality. 

Body pillows are another effective way to align your spine at night and reduce pressure on your lower back and sciatic nerve. If you’re a side sleeper, consider placing a body pillow or regular pillow between your knees to keep your hips, pelvis, and spine in proper alignment. 

Elevate Your Knees

For those who prefer sleeping on their backs, elevating your knees can offer the same type of support and spinal alignment. Bend your knees and place a pillow underneath, elevating both of your knees off of the bed. If one pillow isn’t enough, keep adding more until you achieve a comfortable sleep position you can maintain. Firmer pillows work best for this and won’t crush or deform under your weight. You can also consider a mechanical bed that lets you easily adjust the height and bend of your leg without the need for bulky or uncomfortable pillows.

Find a Comfortable Sleep Position 

Your sleeping position plays an important role in relieving both sciatic pressure and the pain associated with it. We already discussed how to use pillows to relieve pressure, but you should also experiment with how you sleep – on either side, your back, or your stomach.

Side Sleeping

Sleeping on either side in a fetal position is one of the most comfortable and supportive poses for relieving sciatica pain. When you sleep in a fetal position, you open space between the vertebrae in your lower back which may offer some relief. This can prevent and ease pressure on the sciatic nerve. Add a pillow between your knees to better align your spine, hips, and pelvis.

Stomach Sleeping

Most studies and healthcare professionals agree that individuals with sciatica pain should avoid sleeping on their stomachs. When you sleep on your tummy, it flattens the natural curve of your spine, placing unwanted stress and strain on your neck. Even if sleeping on your stomach provides momentary relief from sciatica pain, you should avoid it since it could trigger other issues with your neck and back in the future.

If you can’t stop yourself from turning onto your stomach during the night, consider upgrading to a medium or firm mattress. At least this will give your body the support it needs to stay lifted while also keeping your spine aligned. You can also try placing a firm pillow beneath your abdomen, which has proven especially helpful for those with degenerative disc disease. 

Back Sleeping

As previously mentioned, back sleepers can benefit from sleeping with their knees elevated. The secret to sleeping comfortably on your back despite sciatica pain is to adequately support your lower back. If you don’t have a firm mattress, try placing a pillow under your tailbone or lower back for stability.

There’s no right way to sleep with sciatica pain. Instead, it’s about experimenting with different sleeping positions until you find the one that’s most comfortable for you. This may involve switching from one position to another mid-way through the night. Just be sure to have the right pillows nearby for when you make these adjustments. 

Consider Medication

Even when you do all the right things, sometimes, sciatica pain persists. If so, you may need to consider taking pain medication. Your doctor may prescribe certain medications that offer pain relief when you need it most – like before lying down at night.

Anytime you take medication for pain, even under a doctor’s orders, it’s important to only take it as prescribed. You can also consider OTC anti-inflammatory and pain-reducing medications before bed. Getting adequate rest can also aid in the healing process, giving these medications time to work. 

Explore Other Pain Relief Options

Medication isn’t the only way to find much-needed relief from sciatica pain. Targeted pain relief including heating pads or ice packs can help alleviate pain symptoms. Heat works to ease and relieve tight or sore muscles, while cold compresses shrink the nerve. Both methods can offer pain relief, so experiment with both or ask your doctor which one might be best for your particular condition.

It’s also important to note that not all pain relief options last all night long. While a heating pad or ice pack might help you fall asleep initially, you could still wake up later with discomfort, as the healing effects wear off. Another option is pain-relief patches. Place these localized pads on your lower back, tailbone, or buttocks for longer-lasting relief.

Stretch Before Bed

A body in motion stays in motion. Despite how uncomfortable you might be due to sciatica pain, it’s important to keep your body moving and flexible. Performing routine stretches before bed can help loosen tight muscles, reduce inflammation, and make it easier to find a comfortable sleeping position once you do lie down.

Some of the most effective sciatic stretches can be done on your bed or on a comfortable mat on the floor. Here are a few recommendations to get you started:

  • Knees to chest (Lie on your back and pull your knees into your chest, holding them there for 5 to 10 seconds.)
  • Supine twist (Put your knees together and let your legs drop to one side while rotating your upper shoulders and head in the opposite direction. Hold for 5 to 10 seconds and switch sides.)
  • Figure four stretch (Lay with your knees bent and bring on foot to rest on the opposite knee, creating a “figure 4” with your legs. Hold for 5 to 10 seconds before switching sides.)
  • Pelvic tilt (Lay on your back and bend your pelvis upward by tightening your abdominal muscles and arching your lower back. Hold for 10 seconds and repeat).

All of these stretches are designed to loosen the muscles in your lower back, improve circulation, and reduce inflammation before bed. Just avoid doing any exercises that are overly strenuous or may trigger an adrenaline rush. Doing so will leave you feeling awake, alert, and even further from sleep than you were before. 

Take a Soothing Bath

Nothing eases sore muscles, reduces back pain, or helps you relax more than a hot soothing bath. Add soothing essential oils like lavender or ylang-ylang for greater stress relief. A warm bath not only relaxes sore muscles in the sciatic nerve but also helps your body release pain-fighting endorphins.

Make sure the water temperature is warm and soothing, not hot or scalding. If you don’t have a bath or prefer not to take one, place a water bottle filled with warm water near your lower back, tailbone, or buttocks before bed. Similar to bath water, this water should be warm but not too hot.

Create a Healthy Nighttime Routine 

Easing pain and achieving quality sleep go hand-in-hand. The better you sleep, the less pain you’ll experience and the less pain you have, the better able you’ll be to fall and stay asleep. One way to improve overall sleep quality and duration is to create a healthy nighttime routine. Taking a warm bath and performing routine stretches before bed are two beneficial activities to add to your routine, but they’re not the only ones.

Find ways to relax your mind and body before bed. This can include writing in a journal, drinking warm chamomile tea, meditating, or reading a book. Avoid using electronic devices or looking at a screen like your smartphone, computer, or TV. The blue light from these devices can interrupt your body’s natural sleep patterns. The goal here is to create a calming bedtime routine that leaves you feeling relaxed, happy, and at ease before settling in for the night.

Investing in a comfortable mattress, bedding, and pajamas can not only reduce pain and inflammation but also help you sleep better. Transform your bedroom into an environment that supports healthy sleep habits. This includes reducing light and noise disturbances, clearing out any visible clutter, and maintaining a healthy, cool temperature.

Once you create a sleep routine it’s important to stick to it. This means performing your nightly rituals at the same time each night, even on weekends or while on vacation. You should also create a set sleep schedule that involves going to bed and waking up at the same time every day. The more consistent you are with these healthy sleep habits, the easier your body will adjust to the changes.

Give Yourself a Massage

Massage is another great way to not only relax but loosen sore muscles and relieve sciatica pain. The best part is, you can perform a sciatic massage in the comfort of your home. There are several at-home sciatica massages you can learn and incorporate into your nighttime routine, preventing painful flare-ups during the night.

Here are the two most common sciatica massages and tips for performing them correctly. 

Knuckle Pressure Massage 

Lie on your back and place your feet flat on the floor with your knees bent. Now, make a fist with either hand and place them on your lower back. Make sure that your knuckles are pressing into the flesh of your back. Simply lay here for a few minutes, feeling the constant pressure against your tight back muscles. When you’re done, roll onto your side into a fetal position and rest there for several minutes before slowly standing up. Repeat as needed.

Palm and Thumb Massage

Instead of placing your balled-up fists on your lower back, place your open palms on either side of your lower back. Rub inward toward your spine and then downward toward your buttocks using small but firm movements. Next, place your hands near your waist, grabbing yourself around the sides. In the same way as before, apply firm pressure inward toward your spine. If the pressure is causing pain or discomfort, lighten your grip and press more gently.

Perform these sciatica massages as part of your nighttime routine before or after you stretch or take a bath.

Tips for Preventing Sciatica Pain

Sometimes, the best defense against sciatica pain and discomfort that keeps you from sleeping is a strong offense. Here are a few tips for preventing a sciatica flare-up and promoting a strong, stable neck, back, and spine.

  • Maintain back strength by getting regular exercise
  • Maintain good posture when sitting or standing for long periods of time 
  • Be careful when lifting heavy objects or exercising. Avoid bending over to pick things up. Instead, squat and lift using your legs.
  • Wear supportive shoes
  • Maintain a healthy diet to prevent weight gain, obesity, and diabetes

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Sciatica and Pregnancy

Between 50% and 80% of pregnant women experience some level of back pain, although it’s not always directly associated with sciatica. In some rare cases, the position of the baby can place uncomfortable pressure on the sciatic nerve, causing lower back pain, pain down either leg or numbness.

Depending on the baby’s position and how far along you are, this pain can be temporary or last for the duration of your pregnancy. Sciatica pain doesn’t pose a serious threat to you or your baby but may cause additional discomfort. Similar to relieving traditional sciatica pain, try experimenting with different sleep positions including a pillow below or between the knees or sleeping in the fetal position. It’s best for pregnant women to sleep on their left side to prevent certain life-threatening conditions including reduced fetal growth, stillbirth, low birth weight, and preeclampsia. Prenatal yoga can also help. In most cases, this sciatica pain will resolve itself after giving birth.

When to Seek Additional Help for Your Sciatica Pain

If you’ve tried everything and still can’t find relief from excruciating sciatica pain, you may need to seek medical treatment. Here are a few signs that your sciatica pain may require more than these at-home remedies can offer:

  • Flare-ups last for a week or longer
  • The pain you experience with each flare-up is worse than the previous one
  • The pain is getting gradually worse each day
  • You’re not getting adequate sleep

If your sciatica pain is triggered by a recent traumatic injury like a car accident, fall, or workplace injury, you may need an X-ray or MRI to rule out a more serious problem. The inability to control your bowels or bladder is another sign of something more serious than just lower back pain.

Say Goodbye to Sciatica Pain and Hello to Quality Sleep

For many people, sciatica pain and discomfort can be debilitating. Sharp, shooting pains, pins and needles, and numbness in the legs are just a few sciatica symptoms that can keep you from getting a quality night’s sleep. Without adequate rest, your body is less capable of handling pain and healing itself.

In addition to trying the above techniques and speaking with your doctor about sciatica pain and treatment, improving your sleep can also help relieve some of your discomforts. Let the sleep experts and therapists at Somnus Therapy help ease your insomnia symptoms and put you on the path to a blissful night’s sleep, free from pain. Click here to get started.

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