How to Sleep With Lower Back Pain and Sciatica

Sleeping with lower back pain and sciatica can be quite painful.

While lying down eases the pressure and tension on your lower back, over a few hours spent in bed, you may find the pain returns and sleep becomes challenging. Things get especially bad if you sleep in the wrong sleep position.

The truth is that sleep position matters a great deal to your spinal health—not just if you’re experiencing back pain, but for your spine in general. How you sleep can directly impact your spinal alignment and comfort, which can either reduce or worsen back pain.

In this post, we’ll take a look at why sleep positions matter immensely, and which positions are the best for a good night’s sleep.

We’ll also examine the best sleep positions to ease back pain and sciatica, and explore every aspect of your sleep habits—from your pillow use to your mattress, your sleep hygiene to your pre-bedtime routine—that could improve your spinal health.

By the end of this page, you’ll be well versed in what you need to in order to maximize sleep quality, reduce pain, and encourage a healthy, mobile spine.

Why Sleep Position Matters More Than You Think

Think about it: you spend anywhere from 6 to 8 hours (sometimes more) in bed. While some people move around a lot at night, many fall asleep and remain in the same position throughout much of the night.

That’s alot of time spent in one position. If that position is gentle on your back and caters to the natural curvature of your spine with sufficient support, a night of rest will lead to better spine health. But if that position is incorrect, twists your spine, or fails to offer sufficient support, you’re far more likely to experience back pain.

Add in existing lower back pain (due to injury or strain) or sciatica, and you’ve got a much higher chance that your sleep position will make the problem a whole lot worse.

Best Sleeping Positions to Relieve Lower Back Pain and Sciatica

There are two sleep positions that are ideal for sleep comfort, but can also ease lower back pain and sciatica:

On your side, with sufficient support. That second half is just as important as the first! You should sleep with your knees slightly bent and pulled toward your chest in a simulation of the fetal position and place a pillow between your knees to support your hips. For broader-shouldered people, a supportive pillow in front of your chest can keep you from falling forward while you sleep. With a pillow of proper height to support your neck, you’ll relieve the tension and pain in your back or legs and maximize sleep quality.

On your back. Sleeping on your back may promote a neutral spine and ease the tension on your spine or legs for a while. However, if you’re a back sleeper, you may find that without a pillow, tension increases after a few hours spent in the same position. Placing a pillow beneath your knees and legs will relax your lower back muscles and reduce the pressure on your spine.

What about stomach sleeping, you may ask? Stomach sleeping isn’t the optimal sleep posture if you’re experiencing any form of spinal pain. Because you have to rotate your head to the side to lay on the pillow, the sleep position adds tension starting at the top of your spine and potentially twisting all the way down to your hips (depending on your leg placement).

However, if you’re a stomach-sleeper and just can’t get comfortable in any other position, place a pillow beneath your lower stomach and upper hips to ease the tension on your lower back.

Maximize Sleep Quality Improvement to Reduce Back Pain

How to Use Pillows for Better Spinal Alignment

Pillows will be a game-changer to improve your sleep quality, if placed correctly:

• Beneath your knees. For back sleepers, this can promote a natural curvature of the spine and ease tension.
• Beneath your stomach and hips. For stomach sleepers, this is crucial for maintaining good spine alignment.
• Between your knees. For side sleepers, a pillow between the knees can prevent twisting of the hips that could pull on your lower spine.
• Against your chest. For side sleepers, hugging a pillow to your chest can provide support for your broad shoulders and keep your upper body from falling forward as you sleep.

You’ll want to use thinner, slimmer pillows beneath or between your knees, or beneath your stomach and hips. Against your chest, however, a thicker, firmer pillow will provide more support.

Mattress and Bedding Tips for Lower Back Pain Relief

For those with chronic or acute back pain, a good mattress can be a game-changer. However, bear in mind that “good” changes from person to person—we each have our preferences, and our bodies need different levels of back support.

A mattress that’s too firm won’t cradle your spine or neck, and may be uncomfortable for side-sleepers with large hips.

A mattress that’s too soft, however, may allow your back and neck to sink in, and may be too yielding for side-sleepers with narrow hips.

Always test the firmness of your mattress before you buy. Medium-firm mattresses are often recommended, and spinal alignment and comfort are the most important factors..

Memory foam mattresses can be a good option for people who don’t know what level of support they need. The memory foam conforms to your body and will provide great support for your spine’s natural curvature in whatever sleeping position feels most comfortable to you.

Consider an adjustable bed that can not only change the angle and shape of the mattress (raising/lowering your head, elevating your back or legs, etc.), but also adapt the firmness based on your preferences.

Pre-Bedtime Stretches and Gentle Exercises to Ease Pain

If you’re prone to acute or chronic back pain or sciatica (either during the day or at night while you sleep), spending a few minutes exercising during the day or stretching and doing gentle exercise in the evening can do wonders to reduce tension and ease pain while you sleep.

Try:

• Doing a few Downward Dog transitions, moving between Cobra, Downward Dog, and Lunge positions to get blood flowing to your lower back and legs.
• Give yourself Bear Hugs to loosen the muscles in your upper back (the trapezius and rhomboid muscles).
• Do some Seated Forward Bends to loosen up the muscles in your lower back.
• Get into Child’s Pose and hold it for 1-2 minutes to further loosen your lower back and posterior leg muscles.
• Place your extended legs against the wall and hold that pose for 2-5 minutes to further relax your posterior leg muscles.
• Finish off with a few Neck Rotations, Head Rolls, and Side to Side Head Twists to relax your neck muscles.

Gentle stretching often promotes relaxation and reduces muscle tightness, supporting better sleep.

Pain-Reducing Practices and Sleep Hygiene Tips

Healthy sleep habits and good sleep hygiene can make a world of difference for your sleep quality, which in turn can reduce lower back pain and sciatica throughout the night.

• Wake up and go to sleep at the same time every day to improve sleep quality.
• Maintain a dark, quiet, and cool sleep environment with no distractions that could interfere with deep, restful sleep.
• Limit your afternoon caffeine intake. Have your last cup of coffee no less than 6 hours before you sleep to keep the caffeine from interfering with your sleep.
• Limit your alcohol intake to one drink per night. Too much alcohol can impair sleep quality, even though it makes you feel drowsy and facilitates falling asleep.
• Focus on deep, relaxing breathing as you try to fall asleep. Regulating your breathing can not only oxygenate your body, but also clear your mind of stressful and anxious thoughts.
• Be more active throughout the day. More daytime activity is directly linked to better, deeper, and more restorative sleep.
• Limit blue lighting a couple of hours before going to bed and never sleep directly next to your phone.

Good sleep habits support the body’s tissue repair, recovery process, and overall resilience..

When to Use Heat or Cold Therapy Before Bed

Using heat and cold therapy can be very effective for relieving pain and managing symptoms following a back injury.

The heat therapy will facilitate blood flow to the damaged area, relax stiff muscles, and help you sleep more deeply.

The cold therapy, on the other hand, will stop and reduce inflammation and aid in muscle recovery.

However, some people find it helpful to use heat or cold therapy earlier in the evening, giving the body time to relax before bed. hours before bed.

OTC and Natural Remedies for Nighttime Pain Management

A few OTC and natural remedies to help ease your pain at night include:

• Anti-inflammatory medications like Ibuprofen or aspirin. These can help reduce swelling and ease pain. However, be careful not to take in excess, as they can have side effects ranging from minor to serious.
• Apply Hot Ice, Vicks Vapo-Rub, Tiger Balm, or similar analgesics. The heating and cooling effect can reduce pain.
• Drink turmeric and ginger tea. Both are potent anti-inflammatories that can reduce swelling, and ginger is an analgesic that can ease pain.
• Apply mentholated creams. Menthol can desensitize the pain receptors in your lower back, effectively “turning down the volume” on pain signals.
• Try CBD remedies. CBD has anti-inflammatory properties and, like menthol, reduces the pain signals sent from your lower back to your brain.

None of these pain management techniques are “surefire fixes”, and some can be worth trying to help you manage or ease your lower back pain.

When to Seek Medical Professional Advice for Persistent Sciatica or Back Pain

It’s a good idea to seek medical advice if your sciatica or back pain:

• Began with a specific injury
• Worsens or persists for more than a few days
• Radiates down to your legs (like sciatica does) or to other body parts
• Causes numbness or weakness in your legs
• Is accompanied by infection symptoms like fever, swelling, warmth, and redness
• Is accompanied by unexplained health changes like urinary problems or weight loss
• Reaches the point of debilitating

Some back pain or sciatica won’t reach this level, and many do so it’s important you keep it in mind in case things do get bad enough to require medical intervention.

Long-Term Strategies to Improve Sleep and Manage Chronic Pain

The simplest strategies to help improve your sleep and manage chronic pain are:

• Improve your sleep position. Train yourself to sleep on your side or back, and make sure to use sufficient head, neck, back, and knee support.
• Improve your sleep hygiene. Follow a sleep schedule, reduce alcohol and caffeine intake, and make sure your bedroom environment is conducive to sleep.
• Move more. Exercise is directly linked to better sleep quality, and spending more time stretching and doing exercises to loosen and strengthen your lower back can reduce future likelihood of lower back pain. Make sure to do specific exercise for back pain and use proper lifting techniques.
• Incorporate Yoga, meditation, and other forms of relaxation. A lot of spinal pain is exacerbated by stress, tension, and anxiety. Doing Yoga to relax your body and meditation to calm your mind will do wonders to facilitate better sleep and improve mental health.

Following these sleeping position recommendations and making these lifestyle changes won’t guarantee you’ll be back pain-free forever, but they will support your spinal health, sleep quality, and overall wellness.

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Frequently Asked Questions

What sleep positions alleviate lower back pain effectively?

The best sleep positions for alleviating lower back pain is A) sleeping on your side, and B) sleeping on your back. With the right support provided by pillows—between your knees and in front of your chest when sleeping on your side, or beneath your knees when sleeping on your back—you may significantly ease back pain and support better sleep!

How can I adjust my mattress for sciatica relief?

If your mattress is too firm, switch it out for one that is more yielding and will provide a better cradle for your back and legs. If your mattress is too soft, switch it out for a firmer one that will provide more resilience and won’t sag beneath your weight. When in doubt, opt for a “medium-firm” mattress, which has the best evidence for supporting back and sciatica relief.

How can I use heat therapy while sleeping for relief?

Drugstores and pharmacies sell continuous, low-level heat wraps that you can apply to your back while you sleep. However, it’s smart to protect your skin by wearing a shirt or using some cloth as a barrier between the heat wrap and your skin to keep it from being burned. Avoid sleeping through the night with a standard electric heating pad unless it has an automatic shut-off, as prolonged use increases burn risk.

Sources:

Sleeping positions that reduce back pain

Top 5 Sleeping Positions for Back Pain

5 Things You Should Know about Sleep and Low Back Pain

The Best — and Worst — Sleep Positions for Back Pain

The Best Sleeping Position for Lower Back Pain (And The Worst)

Best Mattress for Lower Back Pain