La sciatica can make your nights a real challenge. If you live with that nagging pain that starts in your lower back and often goes down your leg, you know how disruptive it can be to sleep.
Fortunately, there are practical tips to help relieve your symptoms and improve the quality of your sleep. In this article, I share tips that I have been using with my patients for over 13 years as a physical therapist specializing in back pain.
Why is sciatica more painful at night?
It may seem strange that sciatica is worse at night when you're supposed to be resting. Here are six possible reasons:
- Prolonged static position
Inactivity impairs blood circulation and joint lubrication. Staying in an uncomfortable or twisted position can make sciatica symptoms worse. - Lying position
For some people with lower back osteoarthritis, lying upright can irritate the sciatic nerve, which causes pain. - Exhaustion of drug effects
If you take painkillers, their effect may wear off during the night, especially after 6 to 8 hours of sleep, increasing your pain. - Increased attention to pain
During the day, our activities distract us from the pain. But at night, the quiet and lack of distractions make the pain more noticeable. - Quality of mattress and pillow
An unsuitable mattress can make your pain worse, especially if it doesn't properly support your spine. - Room temperature
Although scientific evidence is limited, some studies suggest that temperatures that are too low may intensify neurological pain, including sciatica.
5 Practical Tips for Sleeping Better Despite Sciatica
1. Treat the underlying cause of sciatica
There are several causes of sciatica, including herniated discs, piriformis syndrome or lumbar osteoarthritis. Each cause requires specific treatments. Consult a health professional to identify and treat the cause of your pain.
2. Do an exercise routine before bed
Gentle, tailored exercise can improve blood circulation and lubricate your joints, promoting better quality sleep.
3. Adjust medication intake
Talk to your pharmacist about when to take your medications to maximize their effectiveness at night.
4. Use heat to relax muscles
A warm hot water bottle placed on your lower back can relax muscles and reduce pain before bed. This creates an environment conducive to falling asleep.
5. Try relaxation techniques
Meditation, deep breathing, or even diffusing essential oils like lavender can promote a calming environment before sleep.
Best Positions for Sleeping with Sciatica
1. Sleep on your back with a pillow under your knees
If your sciatica is worse when standing or walking, this position helps reduce pressure on the nerves by tilting your pelvis slightly.
2. Sleeping on your side with a pillow between your legs
This position prevents lumbar twisting and reduces pressure on the affected leg. Make sure the painful leg is placed on top.
3. Sleeping on your stomach
Contrary to popular belief, sleeping on your stomach can relieve some types of sciatica caused by herniated discs. You can try placing the affected leg to the side in a "figure 4" position to reduce pressure on the intervertebral discs.
The role of the mattress
If you regularly wake up with severe pain, your mattress may be to blame.
Semi-firm mattresses are often recommended for people with back pain, but it's important to find what works best for your situation.
General tips for sleeping better at night
- Keep the room dark and cool
The quality of the sleeping environment is crucial. Make sure the room is dark and avoid too cold a temperature. - Avoid screens before sleeping
Screens can disrupt your sleep cycle. Try to avoid checking emails or looking at your phone before bed. - Write your thoughts
If you have a lot on your mind, writing down your thoughts can help you unburden your mind and rest better. - Limit naps and heavy meals
Try to maintain a regular sleep schedule, limit naps, and avoid heavy meals or drinks like coffee and alcohol before bed.
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References
Patricia Parreira, Ph. et al. (2018). Risk factors for low back pain and sciatica: a general review. https://doi.org/10.1016/j.spinee.2018.05.018
https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.14137
My name is Anas Boukas and I am a physiotherapist. My mission ? Helping people who are suffering before their pain worsens and becomes chronic. I am also of the opinion that an educated patient greatly increases their chances of recovery. This is why I created Healthforall Group, a network of medical sites, in association with several health professionals.
My journey:
Bachelor's and Master's degrees at the University of Montreal , Physiotherapist for CBI Health,
Physiotherapist for The International Physiotherapy Center