If you’re living with sciatica, then even lying down for a nap can be uncomfortable. Your pain might wake you up in the middle of the night, or you find yourself unable to get a solid night’s sleep without feeling stiff and tired the next morning.
You’re not alone, as sciatica affects an estimated lifetime prevalence of about 40 percent in the US. To help us explain why choosing the right position for sleeping with sciatica can help you avoid pain flare-ups at night, it’s important to understand why sciatica occurs.
What Is Sciatica?
Sciatica is a condition of the spine, wherein the sciatic nerve has been damaged or compressed by surrounding tissue. This nerve is one of the longest in the body, originating at the spine and running through the lower back, buttocks, and legs. Sciatica is most often caused by some sort of compression at the nerve’s origin in the spine, although sciatica can also be caused by compression in the buttocks (where an inflamed muscle, called the piriformis, can squeeze on the nerve).
In general, sciatica is a symptom of a greater problem. In cases where one’s sciatic pain is caused by a compression of the nerve at the spine, one of the more common causes is a slipped or bulging disc, often caused by injury. The vertebrae of the spine are hard and bony, but the gelatin-like discs between them are what allows us to flex and twist the spine, and they absorb much of the impact our spine suffers over the years.
Too much pressure all at once or over a period can inflame the disc, and either cause it to swell or rupture, putting pressure on the surrounding nerves. The swelling often goes down on its own, so it’s treated via pain management and patience. Other causes are more complex. Severe spinal stenosis, for example, wherein bony growths or other tissues cause your spine shaft to become abnormally narrow and squeeze on your nerves, may require surgery.
Various tumors and infections can also lead to growths and abscesses in the spine, putting pressure on the surrounding nerves and causing inexplicable pain or discomfort. Treatment for sciatica is as varied as its causes. Some cases of sciatica reveal a condition that typically requires extensive treatment. Other cases of sciatica may resolve themselves, with exercise and healthy posture speeding up the recovery process.
How Can Sleep Positions Affect Sciatica?
While some of the causes of sciatica can be quite severe, in most cases, it is simply a matter of time before the pain passes. The biggest concern for many patients is the pain itself, particularly in how it can intrude on daily tasks and, most importantly, affect one’s rest and sleep. Not getting enough sleep can, in turn, worsen the pain.
Posture has a lot to do with how pronounced sciatica can be. Any sort of additional compression of the nerve can lead to greater pain, while learning to decompress the nerve and utilize targeted stretches to bring about relief can stave off pain.
When sleeping with sciatica, a patient’s position can have an impact on how bad the pain gets, particularly if any twisting or spinal flexion is involved. This can cause further pressure on the sciatic nerve and worsen the pain down a patient’s buttock and leg. On the other hand, observing a few simple tips and tricks can help you reduce your sciatic pain at night, and hopefully even get a full night’s rest.
For Side Sleepers
If you habitually sleep on your side, chances are that you might be sleeping with one knee on the mattress, and the other leg underneath or laid out straight. While laying on your side is ideal for sciatica, it’s important to note that by letting your top knee roll forward onto the bed, you are effectively twisting your spine. In the short term, this can bring some relief as the twisting motion can help decompress the lower back.
But over the course of a few hours, this twist in your lower back can exacerbate your pain. Try grabbing a pillow and holding it between your legs, keeping your knees stacked on top of each other. This way, you keep your hips square with your shoulders. You can try to experiment with your spinal position from here, tucking your knees up towards the chest or finding some other way to comfortably rest.
For Back Sleepers
If you sleep on your back, then the compression of the mattress on your spine might cause you to feel some discomfort, especially if the swelling originates in your lower back. Note that sciatic pain is always strongest in the buttocks and legs, even if it begins in the back.
One way to help alleviate your sciatic pain if you like sleeping on your back is to place a pillow under your knees. You can also experiment with placing a smaller pillow or a soft rolled-up hand towel under the small of your back. This can help your spine decompress while you sleep and reduce your back pain.
For Stomach Sleepers
Sleeping on your stomach is usually the worst sleeping position for any sort of back pain. You’re forced to crank your neck in one direction or the other, it places greater stress on the spine, and it increases the risk of sleep apnea. If you absolutely cannot get out of the habit of sleeping on your stomach, consider a few simple changes.
Begin by removing your pillow (do not use a pillow under your head when sleeping on your stomach) and place it underneath your pelvis instead. This can help reangle the spine in a way that might reduce your discomfort somewhat. Note that sleeping on your back or your side is typically still healthier for the spine, and subsequently for sciatica.
Other Tips for Optimal Sleeping With Sciatica
If you are struggling sleeping with sciatica, it’s important to visit a professional. Sometimes, sciatica can reveal a much more dangerous condition, and diagnosing it as early as possible can help you save a lot of pain and time.
If, however, your only option towards feeling better is to wait it out, then simple posture and movement tips both on and off the mattress can make a world of difference. Movement is important with sciatica, so consider picking up a few simple stretches, and take the time to go for a short walk at least several times a week. Your body recovers faster with a little exercise.