How To Sleep with Sciatica, the RIGHT Way!

man sleeping on the couch

Studies have been done for years that all say the same thing…there is a significant impact on both the quality and the quantity of sleep people get when they suffer from pain.

What researchers haven’t quite determined is if there are differences between acute and chronic pain and the location of the pain and if these have an impact on sleep in the same way. One thing’s obvious, that is, pain changes people.

It has also been determined that 2 out of every 3 chronic pain sufferers also experience sleep issues.

Loss of sleep impacts our body’s ability to heal, repair and rebuild at the cellular level.

Getting enough sleep keeps our immune system in check so we are better able to fight off viral and bacterial infections including the common cold.

Because of lack of sleep, we tend to find ourselves feeling tired, stressed and unable to concentrate. Often this just leads to an increase in pain which then decreases our sleep further.

The leading causes of chronic pain are:

  • Back pain
  • Headaches – here‘s how to prevent them
  • Joint pain including arthritis
  • Nerve pain which includes Sciatica

What is Sciatica?

The sciatic nerve is the largest single nerve in the body and starts, usually, at the 3rd lumbar vertebra (L3).

It has branches, or nerve roots, that exit from the inside of the spinal canal at various levels from in between the vertebrae and discs.

It runs through the buttocks and down the back of each leg. Smaller branches run all the way to the foot and toes.

the diagram of the sciatic nerve

Of course, the main role of nerves is to carry messages through the spinal cord to and from the parts of the body and the brain.

When that ability to carry messages is compromised in any way the messages can get mixed up.

Sciatica is not a diagnosis, it’s actually a word used to describe symptoms that include:

  • Buttock or leg pain, usually only on one side
  • Pain that gets worse when sitting
  • The sensation of burning, tingling or searing
  • Sharp pain that makes movement difficult
  • Pain that radiates down the leg, possibly all the way to the foot and toes
  • Possibly even weakness or numbness or other odd sensations


Causes of Sciatica

It is usually common problems in the low back that lead to sciatica symptoms. These include:

1. Herniated Disc

The spinal column is made up of vertebrae which are the bones of the spine.  In between, there is a soft disc filled with fluid that acts as a cushion through our activities.

It is possible for these discs to “slip” and be pinched which causes some of the fluid to leak out.

This causes the two vertebrae on either side to compress closer together which pinches the nerve as it passes through.

2. Degenerative Disc Disease

Unfortunately, we all age and with that comes common breaking down of body tissues.

That means the discs slowly break down over time and some of the fluid leaks out on its own.

This means the bones get a little closer, like with a herniated disc, and can cause pinching of the nerves as well.

3. Muscle strain

Because the nerves leave the protection of the spinal column and travel into the soft tissue the muscles if strained, can spasm which gets a grip on the nerve and causes sciatica pain.

There are also, many other causes related to sciatica.

To mention a few, spinal stenosis, pregnancy, scar tissue, spinal tumor, infection, and fracture as well as spondylolisthesis where one vertebra slips over the other one and ankylosing spondylitis which is chronic inflammation of the spine.


Relief and Treatment Options

You always need to seek medical attention, especially when you experience this for the first time.

There are plenty of causes and having an x-ray or MRI might be required to make sure that it really is just Degenerative Disc Disease or other minor diagnosis.

1. Surgery is not an option

If it’s more significant than that it shouldn’t be left to worsen. With most of the causes listed above, surgery is not usually an option.  Only rarely would surgery be offered.

That leaves you with a long list of nonsurgical options and it’s often trial and error to determine what works for you and then keep it up.

2. Heat and Ice

Heat and/or ice is always the first treatment option for any injury. Ice should only be applied for the first 24-48 hours and after that heat.

Of course, these can also be alternated with 20 minutes of ice alternating with heat.

Most people find more relief with heat than with ice as heat is more soothing. Technology makes it, even more, easier to deal with pain, through gadgets such as infrared heating pads or cold laser therapy devices.

Don’t forget to always use a cloth or towel between your skin and the pack.

3. Medication

Pain medication is generally what people reach for first, understandably, but it’s important to reach for the right one!

Medications like ibuprofen are anti-inflammatory drugs that help to reduce the swelling caused by irritation of the nerve.

Muscle relaxants do exactly that…relax the muscle so it releases the grip on the nerve.

Of course, there are always narcotics available if your pain is unmanageable but these will only mask the pain for the time you take them.

They can not only cause drowsiness, nausea, dizziness, etc. but you can also get addicted to them and they should be taken only as necessary.

4. Try Relaxation

This can come in the form of a partner providing some massage or a hot bath before bed which improves circulation and increases the production of endorphins which, in turn, helps to reduce the perception of pain.

There are also stretches that you can do before bed that will be beneficial in relaxation and improving flexibility and muscle tone.

5. Seek out a good physiotherapist

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Sciatic Nerve Pain Rehab Ideas! (Swipe Left to see all!…) . . . . 👉🏼Before jumping into the exercises, I think it’s important to note that not all pain in the hip (and sometimes the leg) is sciatica. —— 🔑Low back and radiating pain is complex, and I typically like to start with understanding what movements are irritating and which aren’t. This will heavily guide the treatment. —— 💎The goal of this post is to show you a few options to address nerve tension that can be a contributing factor to this type of discomfort. —- 1️⃣Most of these are variations of nerve glides. Theses are designed to increase your body’s tolerance to nerve tension, and to improve its overall mobility. 2️⃣The seated hip stretch will typically be helpful for those with pain deeper in the hip. 3️⃣The cat cow exercise is a favorite for getting motion back in the lumbar spine, when things are more painful/sensitive than usual. —— 💪🏽Next post we will go over some later stage strength and mobility drill for sciatica! —- 👉🏼Note: this isn’t medical advice, and shouldn’t serve as a replacement for professional in-person care if you are in pain. —— 📢Find this helpful? Save for later and SHARE with a friend!

A post shared by Dr. Adam McCluskey PT, DPT (@theptinitiative) on

Chiropractic and/or massage manipulate either the spine or the soft tissue, or both, which increases blood flow, relaxes the muscles and creates a better environment for healing.

Physiotherapy will help determine where your pain is coming from and help to develop an ongoing treatment and exercise plan.

If your sciatica is being caused by degenerative disc disease, a herniated disc or muscle strain the main goal of physiotherapy is to help you build up the core muscles in the abdomen to better support the spine.

6. Epidural steroid injections

Epidural steroid injections are usually used more as a last resort.

This is done by a pain management specialist who will determine your needs first and then proceed with treatment.

The treatment involves the injection directly into the painful area to help reduce or eliminate the inflammation at that point.

It is definitely temporary relief with most people getting relief for just 1-2 weeks and it doesn’t work for everyone.

The goal of this treatment option is to allow you to work on exercising and, therefore, decreasing your pain.


Sleeping With Sciatica

correct sleeping position with sciatica

As already discussed, getting adequate rest is important for our bodies and our minds.

It promotes healing as well as improves our concentration, decreases stress, aids in repair and keeps us healthy. This is always a challenge so what can you do to improve your sleep?

Here are a few tips on sleeping with sciatica:

1. Start with a good mattress

It’s important to have a mattress that is comfortable but also supportive.

It should support you at the shoulder and hips. The firmer the mattress is not always the best as you can wake up with sore shoulders and hips…the pressure points.

You also don’t want a bed that is too soft either as this will contribute to parts of your body sagging into the mattress.

2. Sleep with extra pillows

If you sleep on your back, put a pillow under your knees to elevate them which reduces the pressure on the discs which, in turn, reduces the pressure on the nerves.

If you are a side-sleeper, placing a pillow between your knees to keep your legs hip-width apart which will also reduce pressure on your spine and keep it in proper alignment.

3. Check the pillows under your head

The angle of your head has a direct impact on your neck and, therefore, the rest of your spine.

Find a pillow that fills the curve of your neck or shoulder and head. This depends on your favorite sleep position which will be very difficult to change.

It’s always easier to work around how you sleep already than to try to change that.

4. Spend time on your stomach

Contrary to popular belief, spending time on your stomach, face down, is the best position.

Because you have to turn your neck in order to continue breathing it ends up falling down the list of best positions. That leaves sleeping on your side with a pillow between your knees being the best option.


Wrapping Up

4 out of 10 people will eventually suffer from sciatica at some point.  Everyone is different as is every case of sciatica. Learning to identify it, what triggers it for you, and what you can do to relieve it can make it more manageable when it does occur.

Living with sciatica doesn’t have to ruin your life or your sleep.


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