Reading Time: 13 min read 
Published: 20/01/2024 
Last Updated: 13/03/2024 
Sleeping can be difficult with any kind of pain, but if you are looking for tips to help you sleep with sciatica, getting a good night’s rest is probably even harder for you. One clinical study found that 77% of their sample of 466 sciatica patients reported sleeping problems, compared to 30% of the general population [1].
Sciatica pain can make it difficult to fall asleep and to remain so because lying down can put pressure on your lower spine, causing significant pain. This is especially true if you are sleeping in certain positions, such as on your stomach.
The good news is that there are things you can do to help you fall asleep faster and rest more comfortably in spite of your sciatica. These include sleeping in a spine-friendly position on a supportive mattress, doing some light stretching, getting a massage or warming up your lower back before bed.
Keep reading to find out all you need to know about:
- The best and worst sleeping positions with sciatica
- Techniques that give you immediate relief for sciatica pain to apply before bed
- Sciatica treatment options
- Warning signs that you may need medical attention for your sciatica
What is sciatica?
Sciatica is a name given to the symptoms which occur when your sciatic nerve (found between your lower back and your feet) is compressed or irritated [2]. In 90% of cases, it is caused by a herniated disc in your lower back which presses on your sciatic nerve [3]. But it can sometimes happen due to a narrowing of your spinal canal in your lower back (spinal stenosis) [4], a back injury or, very rarely, because of a tumour.
You may have sciatica if you are experiencing sharp pain in your lower back, as well as tingling, numbness, weakness or shooting pain in your leg, foot, or buttock [5]. The symptoms usually radiate from your lower back to your leg where they can cause sciatic knee pain. It should be noted that sciatic symptoms are usually limited to one side of your body.
Fortunately, sciatica often improves in 4 to 6 weeks, however, in some cases, it may last longer and require treatment (e.g. physiotherapy, painkiller injections or surgery)[5].
Helpful tips to help you sleep better with sciatica
It can be tortuous to try to sleep when you are in pain, especially if additional strain is placed on your aching lower back. The following tips can help you get some relief for your sciatica pain in bed which will help you get a better night’s sleep:
1. See a doctor about the best treatment for your condition
If you suspect you are experiencing sciatica, it is a good idea to be seen by a medical professional. Your GP can advise you about the best treatment options, ranging from physiotherapy and massage to steroid injections, which will provide relief and help you sleep better at night. They can also rule out a more serious health problem, which may need immediate attention.
Furthermore, your GP may refer you to a specialist, to address the root cause of your sciatica. Unfortunately, since lower back pain accounts for 11% of disabilities in the UK [6], wait times for non-urgent referrals to a back and spine specialist can be as long as 18 weeks or more[7][8].
But the good news is that if you would like to be seen sooner, there are great private healthcare options to choose from. Our top tier orthopaedic and spine consultants at the Harley Street Specialist Hospital will often see self-paying or privately insured patients on the same day. They can provide you with the most effective sciatica treatment, for pain-free days and good nights’ sleep.
2. Sleep on a supportive mattress to get sciatica relief
Many studies have shown that a medium-firm mattress is the best option for providing adequate spinal support and relieving lower back pain [9]-[12].
That is because while a soft mattress can feel comfortable, it does not hold your spine straight, allowing it to sink to an unnatural position during your sleep, which can increase your sciatica pain.
At the same time, while doctors used to recommend very firm mattresses for back pain, research has shown that people who sleep on hard surfaces report the poorest sleep quality [13]. If you are experiencing sciatica and a hard mattress is putting pressure on your lower back, it can cause increased pain and sleep disturbance.
3. Switch to a better sleeping position for sciatica sciatica
When you are experiencing sciatica, you want to put as little pressure on your lower spine as possible while lying down.
While further research is needed to determine the relationship between lower back pain and sleep position [13][14], some scientists believe that lying on your back relieves the pressure on your discs [15], making it more comfortable in lower back pain in comparison to other options.
Sleeping on your back, with a pillow under your head and another, large and firm one under your knees is recommended [5] if you want to get relief from sciatica. That is because it keeps your spine well aligned and takes pressure off your discs and vertebrae.
However, if, like 74% of the population, you prefer to sleep on your side [16], you can also get comfort for sciatica pain by placing a pillow under your head and one between your knees.
This is especially helpful if you are experiencing sciatica in pregnancy, where sleeping on your back can be uncomfortable and is not recommended in the later stages, as it can pose a risk to the foetus [24]. In that case, adding a pillow under your waist (or using a single, full body pillow) can increase comfort.
4. Avoid this sleep position to sleep with sciatica
If you prefer sleeping on your stomach, it would be a good idea to try to find a different sleeping position, at least until you can see clear signs that your sciatica is improving. That is because it puts significant strain on your lower back (as well as your neck), especially if you are using a high pillow fo your head.
If you are also used to sleeping with one leg flexed, it can be even more uncomfortable, as lifting your leg can generally be very painful when you are experiencing sciatica. Doing so accidentally during the night is likely to get your spine in an unnatural position and worsen your symptoms.
However, if you absolutely must sleep on your stomach, you can still somewhat reduce your level of pain by using a thin pillow for your head (or none at all) and a normal one under your belly, to keep your spine aligned.
5. Do some light exercises before going to bed
Light exercises, such as simple yoga or pilates recommended for back pain, can provide temporary sciatica pain relief. While it is not a long-term solution, when done before bed, the effect can last long enough to allow you to fall asleep.
Here are some simple and effective exercises [17] you can do before sleep, some of which can give you a brief sciatica relief in 8 minutes or less:
- Cat-cow pose – starting on all fours, gently round your back upwards while keeping your head down. After holding for a few seconds, slowly transition to pushing your hips towards the floor, while arching your lower back.
- Pigeon pose (piriformis stretch) – while in a sitting position, put the foot of the leg on your painful side on the opposite knee. Then, with your back straight, lean forward from your hips. Hold the position for about 30 seconds, then swap sides and repeat.
- Use the bridge pilates technique – while you are laying on your back, slowly lift your pelvis until a diagonal line is formed from your head to your knees. Hold for a few seconds, then slowly return to the original position. Repeat several times.
- Do opposite arm/leg reaches
While on all fours, slowly stretch out one leg and the opposite arm. Then reach the arm forward while you gently lift your leg. Hold for 6 seconds, then lower your arm and leg and switch sides. Repeat several times.
- Go for a short walk
If you had a long day and don’t feel up for exercising before bedtime, you can just go for a short, slow walk. The fresh air and movement will provide some pain relief and help you fall asleep faster. If you find that your sciatica pain is so bad you can’t walk at all and no home remedy seems to help, you should contact a healthcare provider.
While doing these light exercises can help you sleep better with sciatica, it is not recommended to engage in intense physical activity, such as running, lifting weights or intense cycling. Doing so can put additional strain on your spine and make your sciatica pain worse.
6. Get a massage in the evening
A massage is always nice and relaxing and helps you unwind for better sleep after a long day. This is even more true if you are experiencing sciatica, as research suggests that massage therapy can provide some relief [18][19].
If you have the option to hire a professional massage therapist to visit you in the evenings, before sleep, and perform a deep tissue massage, it would be very helpful to do so. However, you can also ask a member of your household to rub the affected areas or you can even do it yourself. There are several easy and effective massage techniques for sciatica pain relief that can be applied.
If you are planning to give yourself a massage for sciatica pain, you can use a special device, such as a massage belt or gun. Or, if you don’t have any on hand, you can just rub your lower back, affected buttock and hamstring with a hard, smooth, rounded object, such as a tennis ball.
7. Use heat or cold to get pain relief before sleep
Applying a warm compress or a hot water bottle to the affected area can improve blood flow and relax your muscles, relieving some of your pain and helping you sleep better.
Just make sure that you check the temperature of the warm object before placing it on your skin. That is because sciatica can make your affected areas numb or interfere with their sensitivity [5], so you can burn yourself without realising it.
Taking a relaxing, warm bath before bed can also be quite helpful in both reducing your sciatica pain and making you fall asleep faster, as it reduces physical and psychological tension.
However, if it is already hot out or you do not care for heat, you can also use an ice pack to help ease your pain and sleep better with sciatica. While they are not as effective against lower back pain caused by a bulging disc as warm compresses, they can still reduce pain and inflammation [20] and improve your chances of getting some sleep.
If you are using ice, for your cold compress, make sure it is wrapped in a protective layer of cloth or thicker plastic before placing it on your skin, to avoid frostbite. That is because sciatica-induced numbness can alter your sense of temperature.
8. Make lifestyle changes to improve your sleep with sciatica
If you want to get better sleep with sciatica, it is not enough to only take action right before bed. There are things you can do throughout the day that will contribute to lowering your pain levels and helping you get a good night’s sleep:
- Exercise lightly several times throughout the day.
- Get an ergonomic chair which helps improve your posture while sitting.
- Reduce the amount of time spent sitting (if you must sit, take frequent standing breaks and use a lumbar support pillow).
- Avoid carrying your wallet (or other bulky objects) in your pocket when sitting.
- Avoid wearing high heels or uncomfortable shoes that alter your gait.
- Follow a short-term (1 month) low-calorie diet if you are overweight [21].
What makes sciatica pain worse at night?
There are three main reasons why your sciatica pain may seem worse at night and prevent you from getting much sleep:
- Your levels of cortisol, an anti-inflammatory hormone, are lowest around midnight. And since sciatica involves inflammation, this can make your pain more severe after bedtime [22].
- The vast majority of sciatica cases involve a bulging disc which compresses the sciatic nerve. So lying down in certain positions can put additional pressure on your spine, irritating the trapped nerve further. This is especially true if your spine is not well aligned, due to a poor sleeping position or mattress.
- Finally, while during the day you are busy with a number of activities which take your mind off the pain, at night, when you are relaxed and trying to sleep, you have no distractions. That means it is easier for you to focus on the discomfort, which makes the pain seem worse than during the day.
When to call emergency services for sciatica pain which doesn’t let you sleep
While it is generally a good idea to see a doctor if you’re experiencing sciatica pain, be sure to call emergency services immediately if you experience any of the following symptoms [5]:
- Your sciatica pain manifests on both sides (radiates to both buttocks and legs).
- You are experiencing numbness in your genital area or around your anus.
- You have sudden difficulty passing urine (you cannot pee or cannot control when you pee)
- You can no longer feel the need to have a bowel movement or are having bowel movements without realising it.
Is your sciatica pain keeping you up at night?
While it is the most pressing issue, pain is not the only problem that can arise if your sciatica is preventing you from resting at night. Insufficient and unrestful sleep over extended periods of time (such as weeks at a time) can place you at higher risk for cardiovascular illness, weight gain, psychological and mood disorders, type 2 diabetes and brain fog [23]. While in most cases, acute sciatica may resolve in a few weeks, it is likely to return unless its root cause is addressed.
So don’t lose any more sleep over sciatica pain! Book an appointment now with one of our experienced sciatica specialists at Harley Street Specialist Hospital and get rapid, effective pain relief, as well as the best recommendations for permanently solving your spine problems.
