How To Get Better Sleep With Sciatica Pain

The pain of sciatica can make it hard to sleep. Like, really hard to sleep. Fortunately, there are adjustments you can make and steps you can take to ease your pain and finally get a better night’s sleep.

Best sleep positions for sciatica

There’s no perfect sleeping position for sciatica pain. But you may find that one of these options works best for you.

• On your back: Back sleeping promotes good spine alignment, which can bring you nighttime relief.
• On your side: Side sleeping can take pressure off your sciatic nerve, especially if you sleep on the side opposite of your pain.
• Slightly elevated: If spinal stenosis is causing your sciatica, getting your spine into a slightly bent-forward position may give you some relief.

8 tips for sleeping with sciatica

Sleeping and sciatica often don’t mix. It can be impossible to get a good night’s rest when your back or legs are throbbing or tingling! But physical therapist Cara Sieberth, PT, says there are steps you can take to find relief from sciatica and finally get some shut-eye.

1. Align your spine

Getting your spine into a neutral position may help alleviate some of your sciatica pain while you sleep.

When you lie down, ensure that your head, shoulders and hips are in a straight line. Put a small pillow under your neck and head, but not your shoulders. You may also need to put a pillow under your knees to keep your back from arching too much.

“Once you get in this position, think about what hurts or what feels good,” Sieberth suggests. “Then, you can tweak your sleeping position from there.”

2. Use pillows for strategic support

If you’re sleeping on your side, try placing a pillow between your knees.

“This aligns your hips and takes pressure off the pelvis,” Sieberth explains. “Another option is to place a pillow behind your back for support, which also keeps you from rolling.”

Regular pillows work fine. But a body pillow is a great option, too, because they’re designed to mold to your body and stay in place while you sleep.

3. Consider curving your spine

If spinal stenosis is at the root of your sciatica, it can be helpful to sleep in a slightly rounded position. This can help open the narrowed spaces in the spine.

To mimic this position while you sleep:

• Place a large wedge-shaped pillow under your head and upper back.
• Sleep in a reclining chair or adjustable bed with the head elevated.
• Try sleeping in the fetal position (on your side with knees curled up).

A warning, though: If spinal stenosis isn’t the cause of your sciatica, these positions may cause you more pain instead of bringing you relief. If it hurts, switch it up.

4. Beware stomach sleeping

Sleeping on your stomach forces you to arch your back and turn your head to one side. For the most part, it’s not great for your back, and it’s typically best to avoid it when you’re dealing with sciatica pain.

But … not always. In some cases, stomach sleeping could be the one position that brings you the most relief.

“For a few people, arching their back actually provides relief from sciatica,” Sieberth notes. “In general, stick with the sleeping position that feels best for you.”

5. Figure out what you need from your mattress

Sleeping on the wrong mattress can make sciatica pain worse, or at least keep it from getting better.

“Try to find a comfortable position on the mattress you already have,” Sieberth says. “Use your pillows or even a mattress topper to make some small changes. Then, once you figure out what gives you some relief, you can decide whether a firmer or softer mattress might work for you.”

So, what should you look for if you do decide you need a new one? A review of studies found that a medium-firm mattress is best for bringing relief from lower back pain.

Look for something that doesn’t create a lot of extra curve to your spine so you can maintain a normal, neutral spinal alignment.

6. Stretch before bed

Stretching your back and strengthening your abdominal muscles (aka your core) helps take pressure off your spine. To alleviate sciatica pain, try stretches like the piriformis stretch and cobra pose.

“Try both, and if one helps relieve your symptoms more than the others, focus on that,” Sieberth recommends. “Spend one to two minutes stretching three to five times a day, including right before bed.”

7. Try other at-home relief options

Tap into other pain relief options before bedtime to help relieve mild sciatic symptoms.

• Over-the-counter pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen sodium can help reduce inflammation and ease pain.
• Lidocaine patches: These over-the-counter patches are applied to your skin in the area where you feel pain (in this case, your lower back). They provide temporary, targeted pain relief.
• Warm or cold compresses: A little bit of heat, like from a heating pad or hot water bottle, can help relieve soreness, loosen joints and relieve pain. If your sciatica is new (or newly inflamed), an ice pack may bring relief.
• A warm bath: Taking a soothing soak before bed can ease sore muscles and help you unwind, which can ultimately lead to better sleep.

8. Take care of sciatica pain during the daytime, too

Your sciatica pain may feel more noticeable at night. But what you do during waking hours can affect how bad your pain gets at night. Here’s what Sieberth suggests:

• Improve your posture: Practicing good posture helps promote a neutral spine, which reduces pain.
• Get active: Physical activity can increase your core strength, improve your flexibility and help you maintain a healthy weight, all of which can help relieve sciatica pain.
• Try complementary therapies: You may find that massage therapy, acupuncture, yoga and chiropractic adjustments bring you sciatica relief that makes sleep easier.
• See a physical therapist: “Even just a few sessions with a physical therapist can be helpful for many people,” Sieberth says. “They can help you figure out which sleeping positions and activities are best for you.”

Address the cause of your sciatica

To find the greatest relief from your sciatica — both at night and during the day — you need to figure out what’s behind it.

“The cause of your sciatica affects what positions or activities bother you,” Sieberth explains. “This also determines which sleeping positions work best for you. For instance, if you have a bulging disk, you may find back sleeping comfortable. If you have spinal stenosis, you might prefer side sleeping.”

Whatever’s causing your sciatica, don’t assume you have to live with it. If it interferes with your quality of sleep, talk with a healthcare provider about solutions. With the right medical treatment, you can get relief from sciatica pain — and head off to dreamland again.