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A good night's sleep is essential to staying healthy and feeling good. It is also a key component of effective sciatica treatment. However, when you’re in pain, finding a comfortable sleeping position that allows for a restful night sleep can be easier said than done.
Jump to:
- What is sciatica?
- What causes sciatica?
- Best sleeping positions for sciatica
- Worst sleeping positions for sciatica
- How to treat sciatica pain in older adults
- When to see a doctor about sciatic nerve pain
- Frequently Asked Questions about sciatica
What is sciatica?
The sciatic nerve branches from your lower back through your hips and buttocks and down each leg. If this nerve is compressed, irritated or injured for any reason, you may experience pain. We refer to this pain as sciatica.
Sciatica isn’t the same as lower back pain. Lower back pain is limited to pain in an area of your back. But if you have have sciatic nerve pain, you might notice:
- Sharp, burning or shooting pain that travels from the lower back to the foot.
- Muscle weakness in one or both legs or feet.
- Numbness in one or both legs.
- A pins-and-needles sensation in the leg, foot or toes.
Where you feel the pain can depend on which area of the nerve is affected. It could be a constant pain or might only be noticeable when you sit or lie in certain positions.
In this article, we discuss effective tips for sleeping well when you are suffering from sciatica or lower back pain.
What causes sciatica?
While it’s possible to suffer from back pain and sciatic nerve pain at any age, it can be more common in older adults. Age-related changes in the body, particularly the spine, are common causes of sciatica. As we age, the cartilage between bones in the spine can degrade and disappear. This can make it more likely for nerves to be pinched and sciatica symptoms to be felt.
Lifestyle factors can contribute to sciatica. Prolonged sitting, carrying heavy weights and other manual labour and being overweight can put pressure on the body, which increase the chances of sciatica as we get older.
Regardless of age, the main causes of sciatica are:
- Degenerative disc disease: Spinal discs are approximately 80% water but slowly dry out over the years and as a result do not absorb shocks as well as they did. Tears in the disc cause the inside to stick out and press against the sciatic nerve. This can be caused by natural changes in your spine as you age but can also be caused by sports and other injuries. Most people over 60 have some form of disc degeneration but not all will experience back pain.
- Accidents and injuries: fractures, sprains and breaks put extra pressure on the sciatic nerve.
- Slipped disc: sometimes also known as a ruptured, bulging or herniated disc. This where the soft cushion of tissue between the bone presses against the sciatic nerve.
- Spinal Stenosis: Not everyone who has Spinal Stenosis will suffer from sciatica, but it is one of the symptoms. Spinal Stenosis is where the spinal column narrows and the vertebrae compress the spinal nerves.
- Piriformis Syndrome: this is where the piriformis muscle in the bottom irritate or compress the sciatica nerve. It can be causes by muscle spasms, typically from long periods of sitting, overuse during physical activity (especially if twisting or turning a lot) and injury.
- Spondylolisthesis: this is most common in the lower back if a vertebrae slips forward. When this compresses the spinal nerve then you will feel sciatic pain.
Best sleeping positions for sciatica
1. On your back
Place a pillow beneath you knees to help them bend and keep your back supported naturally.
2. On your side
Place a pillow between your knees to help keep your spine aligned with your neck, rather than curving into the mattress.
3. In the fetal position
If you normally sleep on your stomach and experience back pain, the fetal position may relieve pressure on your lower back.
4. Elevated reclined
If you have an adjustable bed then a reclined position can help by reducing pressure on the nerves.
Worst sleeping positions for sciatica
1. Sleeping on your stomach
Many people with sciatica find sleeping on their stomach is uncomfortable and puts pressure on joints and muscles.
2. On your back without support
Lying flat on your back can increase back pain if you do not have anything to support your knees. If your mattress does not provide enough support then this can worsen sciatica pain.
3. In a twisted position
You should try to aim for a position that keeps your spine in a neutral position. A twisted position can put additional pressure on your sciatica nerve.
How to treat sciatica pain in older adults
As with many types of pain, sciatica can feel worse at night, when there are fewer distractions.
We look at ways to help you find sciatic nerve pain relief at night and discuss five effective tips for sleeping well when you are suffering from sciatica or lower back pain.
1. Take a hot bath before bed
Heat can help the muscles and back relax and ease any muscle spasm you may be experiencing. Adding a scoop of Epsom salts to the bath can also aid in reducing inflammation and promoting relaxation that many find offers relief from sciatic pain. In addition, a nice hot bath often leaves us feeling sleepy and can help us to drift off.
If you’re not able to take a bath, try a hot water bottle or a lavender heat pack instead. The heat from these will have the same beneficial effects as taking a bath, and lavender is known for its relaxing properties.
2. Elevate your knees
There is no one-size fits all sleeping position for those suffering from sciatica. However taking pressure off the small joints in the spine can help, as can reducing the stretch in the sciatic nerve. For these reasons lying on your back with your knees raised can provide relief from pain.
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Lie flat on your back with your feet and buttocks in contact with the bed.
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Bend your knees towards the ceiling.
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Slide pillows under your knees until you find a position that’s comfortable.
Alternatively, those who prefer to sleep on their side can sometimes find that this takes pressure off and gives some sciatic nerve pain relief at night. Of course, you’ll need to sleep on the unaffected side and may want to use a pillow between your waist and the mattress so that your side doesn’t need to bend. A pillow between the knees can also be helpful to some and helps prevent leg rotation as you sleep.
3. Keep moving during the day
When you’re in pain, it can seem tempting to rest more and to avoid moving the affected areas. However, with sciatica, pain will eventually increase with prolonged inactivity and decreased motion and so it is important to stay active as much as possible.
There’s no need to exert yourself or push yourself beyond your limits, but try incorporating some of these gentle activities into your day to help minimise the sciatic nerve pain you experience at night:
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Go for regular walks. Even a short stroll to the shop or round the block can help to ease tension in the back and legs.
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Practice simple stretches that you can do whilst sitting in a chair.
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Avoid sitting in the same position for long periods of time. Get up and stretch your legs regularly or spend some time doing activities that require you to stand.
Ideas to help you exercise
When you reach the age of 60, the recommended amount of exercise is 150 minutes, or two and a half hours, per week.
Many people find using a fitness device to track their daily activity good motivation for staying active. A wearable device such as the Taking Care Personal Alarm Watch can count the number of steps you take - and provides a way to get help in an emergency.
Out-and-About Personal Alarm Watch
The watch works as a personal alarm, GPS tracking device and pedometer so you can track how many steps you have taken.
4. Gentle stretches before bed
Doing a few simple stretches before bed can be very helpful for some people suffering from sciatica. For older adults especially, stretching should always be done slowly and carefully, without pushing your body too hard. If any of the stretches feel painful, do not continue with them . Some good stretches for sciatica include:
- Lying on your back (can be in bed or on the floor) and move bent knees slowly towards the chest together
- Doing the same but instead of moving the legs together, move each knee in turn very gently towards the opposite shoulder
- Doing a pelvic tilt by lying on the floor or bed on your back with legs bent, feet flat down and toes facing forward. Gently pulling the belly button in towards the spine as you breathe out will push the pelvis upwards. This can be held for a couple of seconds before releasing.
5. Keep to the same night time routine every evening
While being in pain can make it more difficult to fall asleep, if your body and brain follow the same routine every evening, it helps to prepare for sleep and can mean that you drop off a little easier, even if experiencing some sciatic nerve pain.
That routine can look a bit different for everyone, but as well as the warm bath mentioned earlier, lots of people also find that going to bed at a similar time each night can help, along with getting up at the same time each day too.
Some people like to have a warm drink as they prepare for bed, or wind down with some reading as part of their bedtime routine.
When to see a doctor about sciatic nerve pain
If you’ve been dealing with pain from sciatica for more than a week, you should consider a visit to the doctor for a proper diagnosis. They can help you determine what could be causing your pain and recommend the best treatment options.
TENS machines for sciatica pain relief
TENS machines are small electrical devices with pads that stick on to your skin. They are used to treat pain stemming from a variety of causes, such as period pains, arthritis and Sciatica pain.
Frequently Asked Questions about sciatica
How long does sciatica last?
The NHS website states that “Sciatica usually gets better in 4 to 6 weeks, but it can sometimes last longer”. If the sciatica pain lasts longer than 6 weeks and does not improve then it is considered a chronic condition.
Doctors may suggest waiting to see if it resolves itself without medical treatment and this will be the case for 3 out 4 people. However, you should call 999 or go to A&E if:
- You have sciatica on both sides.
- Experience a severe weakness or numbness in both legs.
- Have numbness around the genitals or bottom.
- Also find it difficult to go to toilet or cannot control when you go.
What causes sciatica to flare up?
There are many different factors, including day-to-day activities such as lifting heavy items, twisting the spine quickly, awkward sleeping positions, and even sneezing, which can jerk your back.
Tight clothing or high heels can trigger sciatica as these can change your posture and put more pressure on your hips.
Anxiety and stress can also lead to sciatica pain. Doctors believe this is because when under pressure, the brain may deprive some nerves of oxygen, leading to sensations associated with sciatica such as leg pain and tingling.
Diet habits and excess weight can also cause sciatica flare ups. If you are overweight, this puts more pressure on your back and sciatica nerve.
Is sciatica hereditary?
Although genetics is not the only contributory factor, scientists have found that a family history of lumbar disc disease increases the risk, particularly in the under 40s. If the sciatic pain is caused by degenerated or herniated discs then hereditary factors are more likely.
Can stress cause sciatica?
Stress can cause muscle tension. If the stress is long-term then it can lead to persistent muscle tension and this can exaggerate an existing or underlying condition. Whilst stress doesn’t directly cause sciatica, it can also affect how we perceive pain and contribute to poor habits such as overeating. These in turn can increase the likelihood of sciatic pain.
