The human body’s most powerful recuperative action is restful sleep, yet it is surprisingly hard to come by when it’s needed the most. Pain can keep us from getting the rest we need – or may lead an otherwise restful night to end with an ache-riddled morning.
Getting quality sleep is about more than just avoiding heavy meals late at night, paying attention to your bedtime, and buying a comfortable mattress. There are other factors involved, particularly how you sleep and how your body moves at nighttime.
If you’ve recently been told that your leg and back pain may be the result of sciatica, or a pinched nerve in your lower back, then understanding how resting posture and general day-to-day activity can have an impact on your sleep – and recovery – is important.
What is Sciatica?
Sciatica in and of itself is not a disease or injury. However, it is a common term to describe cases of lumbar radiculopathy or a pinched nerve in the lower parts of the spine.
The sciatic nerve, which the term is named after, is the largest in the body and has several nerve roots at the lower end of the lumbar spine and the top sacral vertebra (close to the hip). Many cases of lumbar radiculopathy involve the sciatic nerve.
Herniated discs between your vertebrae can pinch surrounding nerve roots, causing pain, weakness, tingling, and other adverse reactions down the length of the nerve. Most back pain can be traced to the lumbar portion of the spine, and these conditions become more familiar with age.
Because the sciatic nerve innervates the muscles on either side of the body, most of these symptoms are unilateral or one-sided, depending on which nerve roots get pinched. Most of the common causes of the pinching are temporary and resolve with rest, recovery, heat-or-cold therapy, and physical therapy. Over-the-counter pain medication helps reduce ongoing pain as well.
But the pain can also be exacerbated or prolonged. This is where your sleeping posture comes into play.
Because the spine naturally bends and twists to allow for basic torso mobility, certain sections of the spine may be put under more or less strain depending on how you sit, stand, lie, or walk. Your spine conforms to your posture, which is why certain stretches can provide relief when experiencing sciatica while others make it worse.
Linking Sleep and Back Pain
The majority of people sleep one of three ways: on their back, on their stomach, or on their side. There are ways in which all three can have a negative impact on spinal health and existing pain conditions.
For sciatica, one of the greatest culprits for prolonging and exacerbating pain during sleep is stomach sleeping. Other positions that may worsen the pain include any positions that involve a twisting torso, sleeping on your side without support, and other positions that bend the lower back awkwardly.
It’s important to visualize how posture and movement might affect your spine. Remember that sciatica is often caused by a pinched nerve root in the lower back.
If you take your hand and place it behind your back, and spread your fingers, the region in question is roughly the length from your little finger to your thumb if your little finger is placed just above the tailbone. Let’s take a look at how different sleeping habits might affect this portion of your back:
If you sleep on your side, the gap between your hips and shoulders will sink deeper into the mattress, causing your spine to bend awkwardly.
Because your knees would be uncomfortably stacked on top of each other, you would likely shift one knee in front of the other, causing your lower back to bend. In this case, you would be both bending and twisting your lower back.
Sleeping on your stomach may cause your lower back to hyperextend instead. Spinal extension is when you bend over backward, whereas spinal flexion is when you curl your back, bending over. Hyperextending the lower back may cause your vertebrae to press against each other more forcefully, thus exacerbating the pinch caused by a herniated or damaged disc.
If you sleep on your back, avoid having pillows or anything else underneath your lower back, and consider how to position your legs. Twisting your spine while your upper backrests square on the bed can still cause more pain for you when you wake up in the morning.
Best Sleeping Positions for Sciatica
The best sleeping position for sciatica is any position that allows your lower back to remain neutral. You can achieve this most easily by:
- Sleeping on your side with a pillow between your knees and potentially under your side.
- Laying on your back with a pillow under your knees or legs. Sleeping on your stomach with a pillow under your belly*.
These simple changes can improve your spine’s posture while you rest and ensure that you aren’t twisting your back, straining your back muscles, or locking up your posterior spine.
*Note: stomach sleepers may still have a harder time resting their neck comfortably, and stomach sleeping generally isn’t recommended for back health.
Useful Tips and Tricks
Sleeping positions can make a big difference in the quality of your sleep, but there are other ways to improve your rest. The biggest change you could make is a totally different mattress.
Discuss orthopedic mattresses with your doctor to get a better idea of what you should be looking for. Most doctors will recommend mattresses that are not too soft or ones that are designed to conform to your body shape in a way that’s healthiest for your back pain.
In some cases, a doctor may recommend that you sleep on the floor to improve spinal alignment at night using a mat. Be sure to discuss this option with your doctor before trying it!
If you continue to experience back pain when waking up, consult your doctor for individual advice. Amending your sleeping posture can help you improve the quality of your rest, but it will not guarantee a pain-free morning. Other conditions may be playing an important role, such as spinal stenosis or facet joints in the spine. Explore better alternatives and sleeping solutions with your doctor. Contact us today for more tips on how to sleep with sciatica.
