Key Points
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Sciatica is a common but painful condition usually resulting from a spinal injury.
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The pain interferes with many everyday activities, but sleeping with sciatica is especially difficult.
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Strategies to help sleep with sciatica include pre-bedtime baths and stretches, bedding changes, and sleeping positions.
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Avoid staying in bed for too long, sleeping on your stomach, stretching your hamstrings, or twisting your body.
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Most sciatica cases resolve themselves within a few weeks or months, but recurring episodes indicate a deeper problem in need of treatment.
Sciatica is a common but very unpleasant ailment that interferes with getting a good night's sleep. The sciatic nerve is the largest in your body, and when it gets irritated, it gets in the way of many activities — even just lying down. Learning how to sleep with sciatica is a real challenge because your favorite sleeping position might suddenly cause you pain, or you fall asleep comfortably enough but wake up with your back killing you.
Fortunately, you can use many methods to alleviate the pain and get a better night's rest, from changing your bedding to taking a bath. Read on to learn the sleeping with sciatica do's and don'ts.
What Is Sciatica?
The sciatic nerve runs down the lower back and branches into each leg. If something damages or inflames the nerve, it causes pain along the route, though it's often more intense on one side. Patients often describe the pain as "shooting" or burning, and frequently experience prickling of the skin in the affected area. Specific movements — bending, lifting, or twisting the body — typically set off sciatic pain.
Somewhere between 10 and 20 percent of people experience sciatica in their lifetime. Typical sufferers are adults, usually middle-aged, and often have jobs involving machinery. Men and women are equally likely to suffer from sciatica, and you're also more likely to get it if you've had it before. Some research indicates a possible genetic predisposition to the condition.
What Causes Sciatica?
Essentially, sciatica is a symptom — to really deal with it, you need to address the underlying cause. If your sciatic pain lasts more than a week, consult your doctor or qualified healthcare provider to see if you can identify the cause.
Possible underlying causes of sciatica include:
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A herniated disc in the spine
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A tumor along the course of the nerve somewhere
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A muscle spasm in the back, pelvis, or leg that pinches the nerve
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Severe obesity
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Piriformis syndrome, i.e., injury or inflammation of the piriformis muscle in the pelvis
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An abscess that develops in the soft tissue between your vertebrae, otherwise known as an epidural abscess
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Spinal tuberculosis, which is a TB infection in the spine that's spread from the lungs
How Do You Treat Sciatica?
Treatment for sciatica depends partly on the underlying cause. More often than not, the condition resolves itself, but a long-term issue like a tumor or persistently herniated disc could require surgery. Infections such as abscesses and tuberculosis need antibiotic treatments. Lifestyle-based causes, such as those related to obesity and activities, likewise call for lifestyle changes; especially if you get more frequent sciatic attacks with age, it might be time to rethink what you do for work or for fun.
Whatever the cause, there are no quick fixes for any of them, so you need to manage the pain along the way. Pain medicines bring immediate relief for sciatic pain, but your doctor might also recommend a course of physical therapy, deep tissue massage, steroid injections, and muscle relaxants.
In addition to the medical treatments, there are also ways to change your behavior and environment that help manage sciatic pain. If you sit at a desk for work, getting a more ergonomic workstation often helps. You must also get up and move around periodically during the workday; sitting in place for too long typically aggravates the pain.
Light, low-impact exercise also usually helps sciatica. If you have access to a pool, swimming and water aerobics provide excellent ways to stay flexible without overstraining your body. Barring that, taking a short walk every day helps you stay loose. Your doctor or physical therapist might also recommend specific exercises for easing sciatic pain.
Sleeping with sciatica, however, presents its own special set of challenges.
Why Does Sciatica Hurt at Night?
Many people living with sciatic pain find that it gets worse at night. The most likely reason for this is that they're lying down. Depending on where the sciatic nerve's sore point is, you can increase pressure on it by lying on your back or on the wrong side of your body. A mattress that's not firm enough is a problem for back-sleepers since their lower back curves due to the lack of support, which increases pressure on the nerve.
Lying on the stomach is also likely to worsen sciatica pain. This also unnaturally bends the spine and increases pressure on the nerve — again, especially if you're on a soft mattress.
What Helps Sciatica Pain While Sleeping?
There are many methods of sleeping with sciatica pain to try out. Not all of them are going to work for you since the precise nature and location of the sciatic trauma varies from person to person. Nonetheless, the experience of doctors and patients alike points toward several methods that usually help.
Take a Hot Bath Before Bed
Muscle tension often worsens sciatica, and hot baths help relax muscles and increase blood flow to reduce stiffness. Applying a heat pack directly to the sciatic pain point, or alternating heat and cold packs, is also a frequently recommended treatment.
Do Some Cool-Down Stretches
Your doctor or physical therapist probably recommended some exercises to help with sciatic pain, but you must avoid working out too close to bedtime. Stretches, however, are often a way to help you get to sleep in general, and they can significantly help sciatica in particular, so long as you don't overdo them and make yourself sore.
The gluteal and pelvic muscle stretches are the key sciatic pain moves. If you haven't done those before, go slowly and gently — too much twisting can make things worse.
Get a Firmer Mattress or Topper
Firm mattresses are key to back and spine support because they keep your body in the correct shape. A soft mattress might feel more comfortable when you first lie down on it, but over time the curvature of your spine from your pelvis and shoulders sinking into it worsens back pain. A firm mattress topper is a good alternative if you don't want to invest in a whole new mattress.
Put a Board Under Your Mattress
Another alternative to replacing your mattress is to put a board directly under your mattress, on top of the box spring if you have one. Plywood is generally the cheapest and easiest to handle, but any boards you have lying around that are strong enough to bear your weight works. This quick fix isn't quite as good as a better mattress, but it adds instant firmness.
Sleep on the Floor
Moving to the floor is an even less expensive way of firming up your sleeping surface. Obviously, you want some padding here — a carpet, camping mat, yoga mat, or cushy bedroll all work. This solution isn't for everyone, but it's worth a shot if you're frustrated with the other methods.
Change Your Sleeping Position
If you usually move around while you're in bed, you've probably noticed that your sciatic pain is worse in some positions than others. If you're one of those people who has a single favorite sleeping position, you might need to retrain yourself into a position that lessens the pain.
Here are a few possibilities:
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If your pain is more intense on one side than the other, try sleeping on the less painful side. Putting a small pillow under your waist helps prevent spinal curving if your hips are significantly wider than your waist.
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Curling up in the fetal position helps some sciatica sufferers, although others say it worsens things. Wrapping yourself around a pillow can make this position more comfortable and even emotionally comforting, like hugging a teddy bear.
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If you sleep on your back, putting a thin pillow between or under your knees sometimes helps keep your spine in the proper alignment.
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Another option for back-sleepers is to put a thin pillow or towel under the lower back — below the waist — to keep the pelvis from tilting the wrong way.
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If you're an inveterate stomach sleeper, try sleeping on your side with a body pillow. That gives you a similar feeling to sleeping on your belly, but it keeps you propped up in a position that's better for your spine.
What Should You Not Do With Sciatica?
Many things seem impossible to do when you're suffering from sciatic pain, so take it easy. Some athletic types try to "power through the pain," but pushing it can make things worse when sciatica strikes. However, even more, relaxing activities carry potential hazards.
Regarding bedtime, check out the following common tendencies to avoid.
Don't Stay in Bed Too Long
At its most debilitating, sciatica pain is so bad you can't walk, so some bedrest is inevitable. Because of the problems with lying around mentioned above, be sure you don't do it for more than 48 hours. Even mild and intermittent activities help keep you from getting stiff.
“Walk around the house for 10 minutes every few hours,” says pain-management specialist Dr. Adeepa Singh. “Sitting or lying around can result in muscle spasms, stiffness, and the loss of mobility.”
Avoid Hamstring Stretches
Some websites advertising sciatica pain stretches advise stretching the hamstrings; it can feel good for a moment. However, doctors say that such stretches increase stress on the sciatic nerve in the long run and can worsen the problem.
No Sleeping on Your Stomach
It's worth saying again: don't sleep on your stomach! It is a favorite position of many people, but it's bad for your back and neck in the long run. Try hugging a long body pillow on one side for that "snug" feeling of stomach sleeping without the spine-twisting dangers.
Don't Twist Around
If you're the toss-and-turn type of sleeper, it's easy to move your legs one way unthinkingly and your shoulders another — but that can aggravate sciatic pain. Strategic pillow application is one way to prevent this: try putting a small pillow between your knees or a whole body pillow to one side to give you a backstop.
How Long Does Sciatica Last?
If all that is making your nighttime life really awkward, the good news is that sciatica normally resolves itself within a few months — sometimes in just a few weeks. Experts advise not stressing out about it too much because the tension worsens symptoms and further detracts from your sleep.
However, it is essential to identify the underlying cause of your sciatica. If it's due to some long-term aspect of your life — your weight, your activities, your furniture, and so on — then chances are good that the problem returns at some point. Snooze's tips for sleeping with sciatica are not here to take the place of a good physician or physical therapist! If sciatic pain is a recurring feature of your life, consult a healthcare provider you trust.
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