A large percentage of people who suffer from lower back pain struggle with related sleep issues. While sciatic nerve pain can range from mild and intermittent to chronic and debilitating, it can make it difficult to get comfortable and disrupt the ability to get a good night’s rest. The best sleep position for sciatica can also vary from one person to the next, but in general, those that promote healthy spinal alignment and reduce nerve pressure are the most effective.
Finding the best sleeping position for sciatica can involve combining positions known to promote spinal alignment with those that bring sciatic nerve pain relief. For some, that means sleeping flat on the back; for others, side sleeping can help relieve some of the pressure on the sciatic nerve.
Before getting into the specifics of sleeping with sciatica, let’s first define the condition and touch on some of its important characteristics.
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The sciatic nerve is the largest in the body. It starts in the lower back (lumbar spine) and extends down the hips, buttocks, and down the back of the legs to the heels of the feet.
The term sciatica refers to pain felt along the sciatic nerve pathway, caused by the nerve being impinged due to uneven pressure/compression.
While sciatic nerve pain is most commonly felt on one side of the body, it can affect both, and pain can range from mild and intermittent flare-ups to chronic and debilitating pain that disrupts daily life.
There are different causes of sciatica, the most common being a herniated disc in the lumbar spine.
The spine’s intervertebral discs sit between the bones of the spine (vertebrae) to provide cushioning, facilitate spinal flexibility, and act as the spine’s shock absorbers, so mechanical stress incurred during movement is evenly absorbed/distributed.
The discs have two main components: a soft gel-like interior and a tough, durable outer layer.
When the soft inner layer pushes through a tear in the outer layer, it can infringe upon the spaces within and around the spine, including the sciatic nerve pathway.
You will hear me mention spinal alignment frequently, which refers to how the vertebrae of the spine are aligned. In a healthy spine, the vertebrae are stacked on top of one another in a neutral and healthy alignment; in order for the spine to function optimally, it needs to maintain its alignment and natural curvatures.
When a spine develops a disc issue, such as a herniated disc, this can disrupt the positioning of affected vertebrae, which can cause the spine to become misaligned, which can also result in the spinal nerves being exposed to uneven pressure.
As sciatica is caused by the sciatic nerve being irritated due to uneven pressure, certain sleep positions can exacerbate this by increasing pressure, while others can relieve it by decreasing nerve pressure and encouraging healthy spinal alignment.
While each case is unique, in general, many people with sciatica find the pain to be worse at night, so let’s start our discussion of the best sleeping position for sciatica by first touching on the characteristics of sciatic nerve pain.
Sciatica is a type of radiculopathy: pain caused by compression of a spinal nerve root.
As mentioned, sciatic nerve pain can be felt anywhere along the nerve’s pathway, which is extensive.
When one or more nerve roots from the L4 (4th vertebra of the lumbar spine) to the S3 (3rd vertebra of the sacral spine) are irritated and/or exposed to uneven pressure/compression, radicular pain can be felt in the lower back, thigh, calf, and/or foot; when it comes to radicular pain, it can be felt far from its site of origin.
If sciatica lasts less than eight weeks, it’s considered acute sciatica; if sciatic nerve pain lasts more than eight weeks, it’s classified as chronic sciatica.
As is the case with a variety of spinal conditions, even the nature of sciatic nerve pain can differ from one patient to the next, and this is determined by a number of important patient/condition factors such as patient age and overall health, condition severity, and the degree of nerve involvement.
The Nature of Sciatic Nerve Pain
Pain is commonly the first symptom of sciatica, indicating nerve irritation or inflammation.
Patients describe sciatic nerve pain in different ways:
Also, sciatic nerve pain is commonly felt on one side of the body, but it can affect both and alternate between the left and right sides.
When it comes to understanding the nature of sciatic nerve pain, and nerve pain in general, it’s important to remember that nerves are like branches on a tree, fanning off in multiple directions, which is why it can be felt throughout the body, and not just at, or around, the affected spinal section.
Most commonly, sciatic nerve pain is felt in the lower back and outer side of the thigh/leg affected, but condition-related pain can also be felt in the front of the thigh/leg, the top/outer side of the foot, the sole of the foot, and between the first and second toes.
Leg pain is a more common symptom of sciatica than back pain, and many patients with sciatica find the pain is worse at night.
Why is Sciatica Pain Worse at Night?
Anyone who has experienced sciatic nerve pain knows how debilitating it can be, and nerve-related back pain is commonly regarded as the worst type of back pain; that being said, each case will have its own unique symptoms and pain levels.
A characteristic of many types of pain is that it worsens at night, and sciatica can also become increasingly unpleasant when a person is trying to get a good night’s rest, and this is for different reasons.
For one, when a person is lying quietly, with no distractions, trying to fall asleep, there is little to focus on other than how one is feeling, and if pain is present, it can feel worse during the night when the distractions of daily life aren’t present.
In addition, certain positions can exacerbate nerve pain, and this is where knowing the best sleeping position for sciatica can help; when it comes to managing sciatica and treating sciatica, the ability to get a good night’s rest can help create an environment within the body that’s conducive to healing and responsive to treatment.
So, how should you sleep when your sciatica hurts? Keeping in mind that every case is different, as long as the spinal alignment is considered, sleep positions that reduce sciatic nerve pain can help manage the condition.
When it comes to optimal spinal alignment, the best sleeping position is flat on the back; this is because the spine is not exposed to any adverse spinal tension due to unnatural positions, bends, or arches and the weight of the body is evenly distributed, so no one part of the spine is exposed to uneven wear.
If a person with sciatica finds that sleeping flat on the back reduces their pain, this position also has the added benefit of being the best for spinal alignment.
For those who prefer side sleeping, there are some additional tips that can help reduce sciatic nerve pain.
If sciatica is felt on the left side of the body (most common), sleeping on the right side, so the left side is elevated can reduce pressure points along the side of the body that is experiencing nerve pain can reduce nerve impingement.
In addition, if there is a noticeable gap between the waist and mattress, a pillow placed in between can provide more support and prevent unnatural side bending.
A pillow between the knees while side sleeping can also help by keeping the pelvis and spine in a neutral alignment and also prevents the legs from rotating during sleep.
While some people with sciatica find that the fetal position exacerbates pain, others find it to bring comfort by opening up the vertebral spaces within the spine so nearby nerves are less irritated: particularly helpful with sciatica caused by a herniated disc.
Any position that brings relief is a positive means of managing sciatic nerve pain during sleep, but the best sleeping positions for spinal health are those that keep the spine in a neutral and aligned position, as this means not exposing the spine, and its surrounding muscles and nerves, to uneven pressure.
Sciatic nerve pain can take on a variety of characteristics, from mild and intermittent to chronic and debilitating.
Sciatic nerve pain is most commonly felt along one side of the body, along the nerve’s pathway, but can also be felt on both sides or alternate between the left and right sides.
Sciatic nerve-related leg/thigh pain is generally more persistent than back pain and can be described in different ways: dull, throbbing, electric shock-like pain, and/or sharp burning pain.
While some cases of sciatica resolve on their own, in many cases, a proactive treatment that addresses the condition’s underlying cause is necessary to help reduce the pressure on the sciatic nerve and prevent further damage.
When it comes to the best sleeping position for sciatica, we are talking about how best to position the body so the spine is optimally aligned and nerve pressure is reduced; sleep-position preference is highly personal, but in general, sleeping flat on the back and/or side sleeping can help reduce sciatica by keeping the spine in a neutral alignment and reducing pressure points along the affected side of the body.
Here at the Scoliosis Reduction Center, I can help patients suffering from sciatica by comprehensively assessing the condition to determine its underlying cause; once a spinal condition’s underlying cause is determined, it can guide the crafting of a customized and effective treatment plan moving forward.
