How to Sleep With Lower Back Pain and Sciatica

A woman sits up in bed with her hand on her lower back. She appears to be in discomfort.
  • Sciatica is a painful condition that results from injury, pressure, or irritation of the sciatic nerve.
  • Common symptoms of sciatica include shooting pains along the spinal cord or back of the legs, numbness, or muscle weakness in the lower body.
  • Sciatic pain can also contribute to lower back pain, although it might not be the only cause for it. This pain can often be caused by muscle strain but may also indicate a more serious underlying health condition.
  • People who experience sciatica often find it challenging to get a good night’s rest because some sleep positions can worsen the pain.
  • The most effective way to alleviate sciatica symptoms is to position your body in ways that relieve compression of the spine. This can be done by sleeping in better positions or making sure that your back, neck, and hips are aligned when you lie down.

Sciatica is a condition that can cause pain along the spinal cord, hips, and down toward the back of the legs.

It affects nearly 40% of Americans at some point during their lifetime and is one of the common causes of back pain.

Lower back pain (LBP) also contributes to sleep disturbances, with one study showing that more than 50% of participants with LBP struggle with getting a good night’s sleep.

Getting a good night’s sleep with sciatica can be challenging because certain positions can worsen your condition. Other positions can provide pain relief and help you get some rest.

This article will help you understand sciatica, its causes, and different treatment options to help you get a good night’s sleep.

What is Sciatica?

Sciatica is a painful condition caused by pressure, irritation, or injury of the sciatic nerve.

The sciatic nerve is the largest nerve in the body, running from the top of your spinal cord to the bottom of each leg.

Sciatica symptoms can worsen if you lie in a specific sleeping position and can even cause chronic pain.

What causes sciatic pain?

Sciatica typically results from a slipped or herniated disc — called spondylolisthesis — which causes inflammation in the sciatica nerve.

You may also have sciatic pain if you have:

  • A compressed or irritated nerve
  • Tight muscles in the back or hips
  • Misaligned vertebrae (the bones of your spine)
  • Lumbar spinal stenosis, or a narrowing of the spinal cord in the lower back
  • Muscle injuries
  • Infections that affect the spineCauda equina syndrome — a serious condition that affects the nerves in the lower half of the spinal cord
  • Spinal tumor, although this is rare

You’ll likely need to see your healthcare provider for tests that can help you determine the cause of your sciatica.

A young woman sitting in a chair at a desk. Her back is arched and she has her hands on her back in discomfort.
Key Point: Differences and Similarities Between Sciatica and Lower Back Pain

Sciatica is a type of nerve pain that is caused by a slipped spinal disc, bone spurs, or nerve damage.

Pain can radiate up and down your spine, but can also be felt in the lower back and legs.

Sciatic pain often occurs suddenly and can take between three to six months before it heals.

Lower back pain can be caused by a number of factors unrelated to sciatica, like accidents that cause muscle injury or something more serious like cancer.

Lower back pain is usually felt around the waist — often called the ‘beltline’ — and tends to stay in one area.

It should also heal within six weeks if the pain is caused by a non-threatening condition.

What are the Symptoms of Sciatica?

The most common symptom of sciatica is experiencing lower back pain. You may also experience the following:

  • Sharp, burning, or shooting pain that seems to travel along your spine and legs
  • Muscle weakness in the legs or feet
  • Numbness in the legs
  • Pins and needles in the legs, feet, or toes
  • Chronic low back pain

Sciatic pain usually originates from the area of the nerve that has been affected. For example, the pain will feel the most intense in your leg if you have a pinched nerve in your thigh.

Pain may also come and go. Some people experience constant discomfort, whereas others only notice pain if they sit, stand, or lie down in certain positions.

How Can I Sleep More Comfortably if I Have Sciatic Nerve Pain?

Finding a comfortable position to sleep in when you have sciatica can be challenging and frustrating.

It may feel like everything you try makes the pain worse. The best way to avoid this is to find sleeping positions that relieve pressure on the spine and small joints.

In this section, we take a look at proven ways to get a better night’s sleep if you have sciatica.

A close-up of a mattress. There are no sheets on the bed but there is a fluffy, white blanket and two pillows. There is a hanging plant to the side of the bed.

Place a pillow between your knees

One study suggests that sleeping on your side with a pillow between your knees may help prevent pain in the spine.

This action helps to keep the pelvis in a neutral position, preventing it from rotating too much.

This can also help keep your spine aligned and relieve the stress placed on the back tissue.

For best results, use a firm pillow that can keep your legs in place. If you have one, you can also use a body pillow for better overall support.

You’ll also want to make sure that you don’t bend your knees too much.

Elevate your knees

If you prefer to sleep on your back or stomach, you may be more prone to lower body pain.

These sleeping positions typically place a lot of pressure on the small joints of the spine and may also cause alignment issues.

You can try elevating your knees to avoid this and reduce your risk of developing back pain.

Do this by bending your knees slightly and sliding a pillow underneath them. You can keep adding pillows until you find a comfortable position.

Choose a medium-firm mattress and pillow

Some research studies suggest using a firmer mattress may help reduce sciatic pain because it keeps the spine aligned throughout the night.

A medium-firm mattress prevents the shoulders and pelvis from sinking down too much as they tend to do with a soft mattress.

When they sink down, this can cause poor posture and contribute to back pain.

Similarly, firmer pillows that offer full-body support can also promote optimal spine alignment and reduce neck pain.

When the spine is aligned, the pressure is also evenly distributed, which helps to minimize the risk of developing sciatic pain.

Put a towel under your lower back

If you can’t afford to buy a new mattress, placing a towel or thin pillow underneath your back may help you achieve the same results.

The elevation helps put your spine in a neutral position, reducing unnecessary pressure on one spot.

The towel also fills the natural empty space or spinal curve that forms when lying down, which prevents the lower back from rounding outwards or slumping.

If the back rounds or slumps, it’s difficult to keep the neck aligned with the spine and can contribute to sciatic nerve pain.

You may also start to experience neck pain.

Key Point: How to Find Your Neutral Spine

A neutral spine is the position where your back and neck are placed under the least amount of stress.

By avoiding unnecessary strain, your back and neck can function properly without an increased risk of damage. A neutral spine also helps prevent neck and back pain.

Finding a neutral spine is relatively straightforward:

  • First, lie on your back with your knees bent and feet flat on the floor.
  • Then try to relax everything in your body by taking a couple of deep breaths.
  • Start performing a pelvic tilt by flattening your lower back onto the floor and curling your tailbone upwards. This is called a posterior pelvic tilt.
  • Next, arch your back so that your lower back comes off the floor. At the same time, tilt your tailbone towards the ground to perform an anterior pelvic tilt.
  • Repeat these two motions a few times.
  • Find a position between the posterior and anterior pelvic tilt that feels the most comfortable. This position should be pain-free and will usually not feel like you are straining to get there.
  • Wherever the midway point is for you will be your neutral spine position.

What is the Best Sleeping Position for Sciatica?

Some sleeping positions — like lying on your back or stomach — can put the spine under too much stress.

This can irritate inflamed muscles, nerves, or discs even more and increase your discomfort.

Luckily, there are some positions that can help you get a good night’s rest if you’re dealing with sciatic nerve pain.

Let’s take a look at the best sleeping positions for relieving sciatic pain.

On your side

Lying on your side is often considered to be one of the healthiest sleeping positions.

It supports the natural curve of your spine, which may help to relieve sciatica symptoms.

Sleeping on your side also ensures that the hips are aligned instead of sinking into the mattress. This may help to prevent hip pain, another common symptom of sciatica.

This sleeping position is also recommended for people who are pregnant because it supports the weight of the baby and relieves pressure on the spine.

Fetal position

The fetal position is similar to sleeping on your side. The key difference is that it requires your knees to be drawn higher up against the chest.

This position opens up space between your vertebrae and may reduce pain associated with a slipped or herniated disc.

When space opens up in your spine, it can also relieve compression and stress. This, in turn, can reduce back and sciatic nerve-related pain.

Sleeping on your back

Depending on the type of sciatic pain you have, sleeping on your back — or lying supine — may be a good option for you.

If done right, this sleeping position can help ease pressure on the sciatic nerve and relieve lower back pain.

To get the most out of lying supine, ensure that your entire body is in contact with the bed before placing a towel or pillow under your knees to elevate them.

Sleeping on the floor

It might seem likely that sleeping on a hard surface would make the pain worse. However, some healthcare professionals agree that this can actually reduce pain.

Sleeping on the floor helps you to maintain the spine’s natural alignment and can relieve pressure on the sciatic nerve.

Make sure that the floor is smooth to avoid putting pressure on other parts of the body. You should also place a yoga mat or thin blanket on the floor to sleep on.

You can sleep in any of the positions mentioned in this section.

How Will I Know Which Sleeping Position is Best for Me?

Finding a comfortable sleeping position will also depend on the cause of your sciatica and lower back pain.

We've put together this table to help you find out what might be most comfortable for you.

Cause of pain Optimal sleeping position
Pinched nerve or muscle injury on one side Sleeping on the opposite side of where it hurts can help relieve pressure and alleviate pain.
Bulging, slipped, or herniated disc Sleeping on your back might provide the most relief from this kind of sciatic pain.
Stenosis or narrowing of the spine Sleeping on your side can help maintain spine alignment and reduce pressure on the hips.

Sleeping Positions to Avoid if You Have Sciatica or Back Pain

Sleeping on your stomach can increase the pressure on your spine and surrounding nerves. It can also increase any existing damage to your nerves and bones.

This can make your sciatic pain significantly worse and may also prolong the recovery process.

Sleeping on your stomach can also have a negative impact on the natural curve of your spine, causing it to flatten.

This can lead to increased pain in the body, specifically around the neck, shoulders, and lower back.

Key Point: Is Something Else Making Your Sciatica Worse?

A number of everyday habits or items can worsen sciatic pain. Let’s take a look at what those are:

  • Wearing high heels or uncomfortable shoes: High heels or uncomfortable shoes can change the weight distribution in your spine, causing your hips to push forward. This can place unnecessary stress on your hamstrings and sciatic nerve, often leading to more pain.
  • Carrying things in your back pockets: Bulky or heavy items in your back pockets can also trigger sciatica, especially if you sit down. These items can press into your sciatic nerve, putting pressure on it and causing irritation.
  • Wearing tight pants: Overly tight pants can squeeze the hips, buttocks, legs, and lower back. The constant compression can put stress on the sciatic nerve and cause it to pinch.
  • Sedentary lifestyle: Sitting too much and being inactive can trigger sciatic pain. Moving around gives your sciatic nerve a break, allowing it to stretch and improve blood flow into the area. Similarly, getting too little exercise can cause the muscles surrounding the sciatic nerve to weaken. This makes the nerve more prone to damage and pain.

Additional Habits to Get Better Sleep

There are a number of additional sleep habits that can help you get better sleep. These can help relax the body before bed, allowing the muscles to soften.

This also helps to relieve built-up tension that can worsen the pain.

Here are some good sleep habits to incorporate into your nighttime routine:

  • Create a sleep schedule: Being consistent with going to bed at the same time every night can help improve your mental health and the quality of your rest. It also helps to choose a time before you go to bed to put away your electronic devices.
  • Exercise regularly: Exercise is a great way to relieve stress and tension in the body. Incorporating light stretching into your nightly routine can help reduce pressure in the sciatic nerve and minimize pain.
  • Take a warm bath before bed: A warm bath can help the muscles in the body relax and let go of tension. It can also stabilize body temperature that tends to drop later in the day. This can induce a better night’s sleep.
  • Create a comfortable sleeping environment: It's often recommended to sleep in a dark, relaxing, and quiet environment. You can also try and keep the temperature between 60°F and 67°F to create the most comfortable sleeping conditions.
A close-up shot cute of three yellow rubber duckies on the ledge of a bathtub.

When Should You Visit a Doctor?

Sciatic pain isn’t something that you should be experiencing for a long time. However, the causes of sciatica are often non-threatening and can be remedied at home.

It’s recommended that you visit a doctor as soon as a week after you’ve started experiencing pain.

This can help your healthcare provider to give you a proper diagnosis and treatment recommendations before your condition becomes too serious.

They can also keep an eye on your sciatica and adjust your treatment if necessary.

Are You Struggling With Sciatica?

Sciatica is a common condition experienced by many Americans. Although it’s not usually necessary to worry about it, this pain can be uncomfortable and interfere with quality of life.

If you’re experiencing some of the symptoms we’ve covered in this article or are worried about sciatic pain, head over to LifeMD and make a telehealth appointment with a board-certified doctor or nurse practitioner.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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