• Dr. James Fonner

How to Sleep with Lower Back Pain and Sciatica

Sciatica and lower back pain are conditions that people often mix up because their symptoms are similar. The reason is that the sciatic nerve pain and back pain location tends to coincide. Although there are some distinctions between them and learning them can be crucial, patients can deal with them as if they were the same when it comes to sleeping.


These causes of pain are different, but both are significantly distressing. They make whoever suffers from them unable to get a good night's rest. Anyone would find it challenging to sleep if they feel their back and legs stinging and throbbing.


Nonetheless, there are some actions people can take to mitigate the symptoms while sleeping with sciatica or back pain. This article explains what sciatica is, its causes, symptoms, how to sleep with it and lower back pain, and other helpful information.


What Is Sciatica?


People suffer from sciatica when their sciatic nerve endures an injury, irritation, or inflammation. This nerve originates in the gluteal area in the lower back. It's the longest and thickest nerve the body has, and it comprises five nerve roots. Two are from the lumbar spine, and the rest are from the sacral region.


These five come together to form the sciatic nerve of both legs, which pass through the hips, buttocks, leg, and end below the knee. At this point, it branches to other nerves, reaching the foot and toes.


It's actually hard for people to injure their sciatica, so many use the term to describe any lower back pain that propagates down the leg. Coincidentally, when the pain doesn't radiate through the legs, people are unsure whether it's lower back or sciatica pain.


How Does Sciatica Pain Feel?


Patients characterize the pain in various ways, depending on the cause. For example, some describe it as a shooting or jolting pain sensation that originates on the lower back and propagates further down the legs. Others distinguish it as a burning, stabbing, or electric feeling.


The pain may come and go, but it mainly focuses on either leg. It may worsen for people who remain standing or sitting for long periods or when they twist their bodies. Forced and abrupt actions can aggravate it as well. Sciatica usually affects a single leg. It causes pain in both only in rare cases.


What are the causes of sciatica pain?

What Are the Causes of Sciatica Pain?


Sciatica is an umbrella term that describes the effects caused by an underlying condition with multiple different causes. Technically, it isn't a diagnosis by itself. Here are some common medical conditions that can cause it:

  • Spinal disc herniation due to compression or inflammation

  • Lumbar spinal stenosis

  • Spondylolisthesis

  • Degenerative disc disease

  • Muscle spasms

  • Sacroiliac joint dysfunction

Other causes such as blood clots, tumors, and various back conditions may cause sciatica as well. Finding out the cause of sciatic pain allows people to address it. After all, it affects which position or activity may be bothering them.


For example, someone with a disc herniation might find it easy to fall asleep on their back. Meanwhile, another person with spinal stenosis might feel relief by sleeping on their side.

Regardless, the problem might be distressing enough to require a doctor or a physical therapist visit. They can recommend an appropriate sleep position based on the cause and check up on the condition as it progresses.


Finding the Best Sleeping Positions


Sciatica pain and other sources of it can devastate sleep quality. In fact, around 55 percent of people with chronic back find their sleep disturbed by the condition.


Finding the best sleeping position to alleviate sciatica pain can be a simple matter of trial and error, but it isn't easy. However, doctors recommend laying in a way that makes it easy to maintain a natural spinal alignment at first to provide some relief.


The reason is that posture significantly influences how painful sciatica can be. Any sleeping position that puts additional stress on the sciatic nerve can quickly magnify the problem.

A posture that can decompress the nerve while sleeping can provide considerable pain relief, as does learning to perform particular stretches. Here are the best sleeping positions for people who suffer from sciatica pain.


Sleeping on the Side

People who sleep on their sides mitigate sciatica pain by reducing the pressure their spinal nerve suffers.


They can lie on their mattress with the injured leg on top. If there's a gap between the bed and hips, it's a good idea to fill it with a small pillow as it reduces side bending.


Sleeping in a Fetal Position

A fetal position can reduce the sciatica pain that a herniated disc causes by freeing space between the vertebrae. However, certain people find this posture painful.


Whoever tries this sleeping position and doesn't find it comfortable should move on to the next one. It's vital to find a comfortable position as experiencing pain can be detrimental to recovery.


Regardless, people can try sleeping in this position by laying on their side and bringing their knees up to the chest, making a C-shape with their body. Afterward, they can place a pillow beneath the waist or knees if there's space for it.


It's also possible to sleep in a reclining chair or an adjustable bed with the head elevated to achieve the same effect.


Sleeping with a Pillow Between the Knees

Putting a pillow between the knees can improve a person's spinal alignment by promoting a neutral sleeping posture. It also prevents the legs from rolling around afterward.


People who wish to try this setup should put their heads and shoulders to the mattress and settle their bodies against it.


Then, bend the knees slightly and place a pillow in-between. Finally, people can put a pillow under the hips, just like in the fetal position, if there's a suitable gap.


Sleeping on the Back with a Pillow Beneath the Knees

This neutral position should work for most people, as lying on the back distributes the body's weight evenly.


Doing this and placing a pillow beneath the knees can mitigate sciatica symptoms and maintain the spinal alignment by loosening up the hip flexors. People should add as many pillows as required until they find a comfortable position.


Sleeping with a Towel or Pillow Under the Back

People can keep their spine in a natural position by placing a towel or a small pillow under their back as it reduces the gap between them.


All it requires is to lie facing upward with a pillow properly supporting the head and neck and then slide a thin towel or pillow under the back. Combining this and putting a pillow beneath the knees can result in better sleep and pain relief.


Sleeping on the Floor

Although there's only anecdotal evidence that this position works, it may prove helpful for some. It requires people to lie on a thin mat such as a camping or yoga mat on the place they intend to fall asleep.


Then, they should try the sleep positions listed before until they find a comfortable one. However, if they don't find one that provides relief promptly, it would be best to go and lie on a mattress to try another method.


Sleeping on the Stomach

Laying on the stomach is the worst sleeping position for any sciatica or back pain. This posture forces the neck to turn in either direction, increasing the stress and pressure the spine endures and the risk of sleep apnea.


However, people that can't get out of this habit can consider some tips. For example, they can sleep without a head pillow and put it underneath their pelvis for support instead. It slightly reangles the spine and may provide relief for some.


Is It Necessary to Get a New Mattress or Pillow for Sciatica?


There isn't a mattress that works equally for everyone. Some find relief in a firm mattress, while others might feel better sleeping on the floor or with an extra cushy pillow and mattress.

People don't need to get a new mattress immediately if they suffer sciatica pain. Instead, it would be best to try and find the best sleeping position with their current one.


They can use pillows or a topper to find the best sleep positions that mitigate their sciatica symptoms. However, should they find nothing that relieves their sciatic pain, it might be good to consider either a new soft or firm mattress.


A memory foam mattress doesn't work because they lose their shape too quickly. Side sleepers usually benefit from a soft one. Back sleepers might find a medium-firm one preferable. Lastly, people who sleep on their stomach may prefer a firm mattress to keep their spine aligned.


What Pillows Are Suitable for Sleeping with Sciatica?


People can use most pillows to accommodate their sleeping positions the best way they can. Therefore, their shape, density, and contours might not matter when using them to elevate the knees.


However, some side sleepers may require smaller pillows as they mostly use them to fill small gaps. A contoured one might be great for them as well.


People who lie on their stomachs might prefer a flat pillow as it helps align the spine. They shouldn't use one to support their head, as previously mentioned, but a completely flat one might prevent neck strain.


Some options people have are cylindrical pillows, bed pillows, and wedge pillows. Regarding memory foam and down pillows, it mostly depends on the preferred firmness.


Sleep with lower back pain and sciatica

Other Simple Tips for People Sleeping with Sciatica


People can do a couple of things to find relief from their sciatica and back pain besides finding the best sleep position. Some are already mentioned, like purchasing a better mattress or getting good pillows if necessary.


Regardless, when it comes to sciatica, it's better to evaluate all options and tips available. Here are some tips that can help people fall asleep quicker and more comfortably.


Take a Bath before Bed

People can relax with a warm bath. It releases endorphins that slightly mitigate pain and loosens up the muscles surrounding the sciatic nerve roots. These baths should be warm and pleasant, not hot. An alternative to it is applying a warm water bottle to the back before heading to bed.


Stretch before Bed

Doctors don't usually recommend exercising before heading to bed, considering it can take away the desire to sleep. However, there are stretching routines that are helpful and reduce the pain from sleeping with sciatica. People can do most of them without getting out of bed. Here are some examples:

  • Pelvic tilt

  • Figure 4 stretch

  • Knees to chest

  • Knees to opposite shoulders


Take Prescribed Medications

Patients who have already visited the doctor and received pain medications should take them as prescribed and catch up on some sleep. People who wish to avoid prescribed medications can pick some over-the-counter anti-inflammatory pills or MMJ to get at least some relief before they try sleeping.


Massage Therapy

Massage can significantly ease sciatica and back pain. It helps people sleep much better and lets them get an excellent rest. Learning them at home is possible, and they might even become part of a bedtime routine, but many people consider it too much effort. Regardless, here are some basic techniques:

  • Knuckle pressure massage: While lying on the back with the knees bent and feet flat on the floor, place a clenched fist on both sides of the back in a way the knuckles apply pressure to it. Wait a couple of minutes and then roll on the side into a fetal position for five minutes before standing.

  • Palm & thumb massage: Place the palms on the back and rub them towards the spine and downwards towards the buttocks. Afterward, place the hands at the waist and wrap the fingers around the body while applying firm pressure without causing discomfort for a while.


The Bottom Line


Sleeping with sciatica or back pain doesn't have to be utterly unpleasant. There are many techniques, positions, and tips that allow people to find the sleeping posture that best works for them. It lets them get the much-needed rest that the body requires to repair itself.

Most of these sleeping positions provide excellent spinal alignment and can likely make people enjoy a proper rest. However, it's crucial to speak with a healthcare provider or Columbus chiropractors about it and possibly about physical therapy.


A few sessions can work wonders as the therapist can identify the best sleep positions and activities for the patient. After all, sciatica is a harsh condition that affects everyone differently, so it might be hard for people to stumble upon the right solution by themselves.

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