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3 Back Pain Experts Show You How to Sleep Better with Lower Back Pain and Sciatica

Published May 5, 2020
| Written By SpineNation Editorial Staff   | Medically Reviewed by Jerry Nichols, MD

Common sciatica symptoms, like constant radiating pain or tingling in your lower back all the way down your legs, can interrupt a good night’s sleep. Although there is no cure for sciatica, there are conservative treatments, therapies, lifestyle changes and sleeping habits that can minimize discomfort while you’re sleeping with lower back pain and sciatica. 

We called on a few of our expert health professionals to answer your questions about how to sleep better with lower back pain and sciatica.

What would be the best sleeping positions for someone with lower back pain or sciatica?

For most people, sleeping on your back with the knees bent at 45 degrees is the most comfortable position, but this may vary from person to person. Place a pillow/bolster under your knees while sleeping to help take pressure off your back and sciatic nerve. This way the body is in its normal spinal alignment and the knee flexion reduces pressure on the affected sciatic nerve so you can sleep. A firm mattress is usually recommended for this condition, but some people feel that laying on a hardwood floor is more comfortable during a sciatica flare-up. If you must sleep on your side, then try having the leg with sciatica symptoms flexed to 45 degrees towards you while sleeping, and place a pillow under that leg so the body can comfortably rest in that position. The non painful leg should be the side you lay on while you sleep in this position. Others sometimes can not find comfort during a flare-up and will sleep in a recliner with their legs elevated, which mimics the first sleeping position we described above.

Dr. Allen Conrad BS, DC, CSCS
Montgomery County Chiropractor Center

How can regular massages help combat sciatica pain for better sleep?

Regular or weekly massages can help combat sciatic pain for better sleep because massage therapy promote sleep and helps to get rid of the scar tissue that causes pain. Hence, via massage, you get reduced scar tissue, which reduces pain significantly, and you naturally sleep better when pain is reduced.

What other therapies, exercises, or stretches can patients do at home for sciatica and lower back pain relief before bed?

There are tips, tricks, exercises, and stretches, but at the end of the day, the client has to do what’s best for them in their personal journey to reduce their pain. Some ideas include stretching specific muscle groups such as: quadratus lumborum (a pair of lower back muscles that start at the base of your ribs and ends at the top of your pelvis), hamstrings, glutes along with the iliotibial bands (large tendons running down the side of the leg from the hip).

In my 13 years of massage therapy experience, the most effective treatment is a 90-minute deep tissue massage combined with a little heat for about 15 minutes, then stretching 15 minutes, optional CBD oil treatment, icing the area for two minutes, and then applying heat again. CBD oil combined with heat will always be the most effective cocktail for going to sleep pain-free.

Mayhew cautions that heat is not always the best way to relieve your sciatica treatments.

Due to the regular use of the heating pad, the muscles become stretched, flaccid, and weak causing more pain because these clients usually assume that if they sit or put their legs up or just sit for long periods of time, that their back will not bother them. This is wrong because you have to massage scar tissue out of the area affected from origin to insertion, and use the treatment plan provided by your massage therapist. Sitting for long periods of time and standing for long periods of time are what really aggravate the sciatic nerve.

These treatments and lifestyle changes are the first things to consider while trying to sleep with lower back pain and sciatica. When the time comes to go to sleep, that back pain may linger and make getting to sleep and staying asleep a hassle. Our experts take a look into how your sleep habits and environment can cause sciatica pain to flare-up at night.

Stephanie Mayhew, MCBTMB, CMT
Licensed Massage Therapist

What are the best mattress types for those with sciatica pain? Are there any other pillows or bedding that can help ease sciatica pain at night?

Sciatica can be extremely painful for those who suffer from the sharp radiating pains from the lower back down to the legs. When looking for a mattress to help with sciatica, it is encouraged to find a sleep surface with excellent conforming ability. Both memory foam and latest mattresses could be an excellent choice with the components ‘hugging’ the body of the sleeper while alleviating as much pressure as possible. It is also recommended to utilize a pillow that properly supports the head and neck, thus keeping the spine aligned. While it may seem a bit odd to be concerned about the head and neck when it comes to sciatica pain in the lower back, if our spine isn’t properly aligned, our muscles fight to find that correct alignment and the pain can run all the way down the back.

What bedtime routines can help someone with lower back pain or sciatica get to sleep and stay asleep?

As far as a sleep routine, consistency is key. Our bodies crave a ritual. By doing our best to start our sleep process at roughly the same time each night and waking at the same time each morning, our body gets into a rhythm where it instinctively knows when to sleep and when to wake. The second thing we can do is take a deep look at our sleep environment. Our bedrooms should be set up as a sleep sanctuary of sorts. Many of us use our bedroom for folding laundry, packing, watching TV, etc. To truly make it a sanctuary, we need to focus solely on sleeping. That means getting rid of all electronics. To some that may be impossible, but it is possible to charge your devices in another room. Instead of tearing the television off the wall, make a point to not allow television in the bedroom within an hour of going to sleep.

Beyond removing electronics, a nice investment would be blackout shades and a white noise machine. Many people look at their bedroom from the perspective of how easy it is to fall asleep. We should also look at it from the mindset of how easy it is to stay asleep. A quality white noise machine will mask the garbage truck going through your neighborhood at 6 a.m., or the dog that seems to want to bark all night. Along those lines, if you operate on a schedule that you don’t need to wake up with the sun rising, it is in your best interest to install blackout shades so the rising of the sun will not wake you. With some time and effort, you can arrange your bedroom in a manner that is conducive to sleeping, which is especially important when dealing with sciatica pain.

Bill Fish
Certified Sleep Science Coach and Co-founder

Updated: May 9, 2020

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.

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