Sleeping with lower back pain and sciatica can be difficult and frustrating. What are ways to get more comfortable sleep?

Sleeping With Lower Back Pain and Sciatica

Various factors can affect sleeping with lower back pain and sciatica, including age, injury and medical history, the mattress (e.g., soft vs. firm mattress), and sleep positions. Unfortunately, there’s no one-cure-all solution for this problem, and depending on the underlying cause/s, they can worsen the pain and cause sleep problems. For example, if a herniated disc places added pressure on the nerves in the lower back, twisting the spine can worsen the lower back pain, and sleeping in a fetal position can exacerbate the nerve pain. (UCF Health, N.D.)

Lower-Back Pain

Low-back pain can be activity-related, intermittent, or constant. (American Association of Neurological Surgeons, 2024) For some, it only occurs occasionally, such as when performing specific movements. For others, it can be excruciating, chronic, and disabling. Low-back pain is unique for everybody and can differ depending on the cause. Some low-back pain symptom descriptions include (Förster M. et al., 2013)

• Aching pain deep in the back
• Shooting pain flare-ups
• Pain caused by slight pressure
• Burning
• Tingling

Sciatica Not Present

For some, low-back pain may be confined to a specific area known as axial back pain. (Förster M. et al., 2013) The pain may be felt in a band along the lower back and does not radiate down the legs or anywhere else.

Sciatica Present

Low-back pain with sciatica pain that radiates from the lower back or hip down the leg is the most common symptom of lumbar radiculopathy (compression of spinal nerve roots). (North American Spine Society, 2020) Sciatica symptoms include: (American Academy of Orthopaedic Surgeons, 2021)

• Shooting pain from the lower back down the leg
• Feeling like a bad leg cramp
• Leg weakness
• Sensory changes radiating down the leg – numbness, burning, and or tingling

Sleep Tools

Consider changing the mattress to improve sleeping with lower back pain and sciatica. For the best spinal support, choose a medium to firm mattress. Pillows, wedges, and other tools can also help improve sleep. (UCF Health, N.D.) It is recommended that individuals who sleep on their backs place a small pillow under their knees to reduce pressure on their lower backs. For those who sleep on their side, placing a pillow between the knees can keep the spine in a neutral/straight position. To relieve lower back pain, consider sleeping in a reclined, angled position with the head and shoulders higher than the hips. This can be accomplished with an adjustable bed or a wedge to prop the body in a regular bed.

Back Sleeping

Easing back pain while sleeping involves maintaining the body in a neutral or straight position. Extending the muscles, tendons, and ligaments too far in any one direction while sleeping with lower back pain and sciatica can cause stiffness, muscle spasms, and pain. Sleeping on the back puts the spine in neutral alignment with the least stress on the neck and back. It evenly distributes body weight to avoid exerting pressure on the joints and prevent backaches. In addition, a supine position allows outstretched ligaments to shrink and recover to their normal positions. (Keck Medicine of USC, 2019)

Chiropractic Assessment

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team may be best for individuals with acute back, neck, and musculoskeletal pain and discomfort symptoms. A chiropractor can quickly assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

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Sciatica, Causes, Symptoms and Tips

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References

UCF Health. (N.D.). The best sleeping position for lower back pain (and the worst). ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

American Association of Neurological Surgeons. (2024). Low back pain. www.aans.org/patients/conditions-treatments/low-back-pain/

Förster, M., Mahn, F., Gockel, U., Brosz, M., Freynhagen, R., Tölle, T. R., & Baron, R. (2013). Axial low back pain: one painful area–many perceptions and mechanisms. PloS one, 8(7), e68273. doi.org/10.1371/journal.pone.0068273

North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of low back pain. North American Spine Society. www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf

American Academy of Orthopaedic Surgeons. (2021). Sciatica. orthoinfo.aaos.org/en/diseases–conditions/sciatica

Keck Medicine of USC. (2019). The best -and worst – sleep positions for back pain. Keck Medicine of USC Blog. www.keckmedicine.org/blog/the-best-and-worst-sleep-positions-for-back-pain/