Getting a GOOD NIGHT'S sleep with low back pain or sciatica

Posted by Eileen Pelletier on August 06, 2018. 0 Comments

Paul Boxcer 01/01/2017 12:56

Getting a GOOD NIGHT'S sleep with low back pain or sciatica

When I see clients who are suffering with low back pain or sciatica, this is a question I am commonly asked. It is an important question to ask as well, as getting a good night’s sleep is imperative if you are to resolve your pain as soon as possible.

Night time, as most people know, is prime healing time. It is when the body really sets about healing itself, it is therefore vitally important we utilise this to its optimum. If we do not, a vicious cycle can often result... 




This is where the pain being felt results in a poor night’s sleep. The poor night’s sleep itself leads to decreased healing taking place and therefore, with the lack of healing taking place, increased pain is felt, which leads to a poor night’s sleep and so on…

How can this be addressed? If your pain is preventing you from getting a good night's sleep, there is  a fair chance it has nothing to do with the bed you are sleeping on, but rather the things you have been doing before you go to bed, or the position you are sleeping in while in bed. For the rest of this blog, I am going to be discussing the latter i.e. the position you are sleeping in.

There are typically three different positions we sleep in, prone lying, supine lying or side lying. We will have a look at them now:

Prone Lying

This refers to lying on your stomach.

 In this position, the laws of gravity and the give in the bed (even the firmest of mattresses will have an element of give in them) will encourage your back to arch down towards your stomach. This 'arching down' of the back is referred to as extension, and if your low back pain or sciatica does not like extension based activities, it is highly likely that this position is going to aggravate your pain, and therefore wake you up or give you a restless night.

An alternative to try, if you really find it difficult to sleep in any other position, is to place a pillow or two under your stomach. This will prevent your back from 'arching down' as much and some people find they can gain some relief this way.



 Supine Lying

This is the complete opposite to Prone Lying and refers to lying on your back


 When in this position, the laws of gravity and the give in the bed can encourage the back to arch in the opposite direction to prone lying i.e. a position of relative flexion. However, as is typical of the human body, things are not quite as straight forward as they’d seem. I am saying this because if there are tight muscles present at the front of the hip, and/or you have decreased stability about your low back and pelvis, this can result in the opposite being true when lying in this position i.e. encourage the back to arch upwards toward the ceiling into a position of relative extension. This will therefore have the potential to aggravate low back pain or sciatica which does not like extension based activities, similar to prone lying.

If you feel this may be the case with yourself, I would suggest you try lying with your knees bent as shown below (often referred to as crook lying), it will be easier to place some pillows under your knees to keep them bent while sleeping though.



Side Lying

As a rule of thumb, I tend to find side lying the best position to sleep in. However, you will need to use a pillow or two for some support.  In the diagram below, you can see how the typical position for someone to adopt when lying on their side, is where the top leg rolls forwards and down.



Even if you start off in the foetal position, the top leg typically drops ‘down and forward’ which places a twisting stress on the lower back as well as the soft tissues of the lower back, buttock and upper leg (which will include the Sciatic Nerve). If you were to sleep in this position, these increased stresses would potentially aggravate your pain, resulting in you waking during the night or waking in the morning with increased pain and stiffness.

On the other hand, if you were to place a pillow or two underneath your top leg for support...


This will help maintain the spine in a  more neutral position, which in turn will decrease the stress placed across the lower back and associated structures, resulting in a better night's sleep.

Of all the positions I have covered above, it is the usually the last position, side lying with some pillows for support, which people find the most beneficial. However, without sounding too flippant, the best position for you to sleep in is the position where you get the best night's sleep and wake up feeling most comfortable in the morning.

Based on what I have written above, try the positions which you feel will give you the best night’s sleep, but ultimately listen to your body. If you are sleeping in a position which your low back pain or sciatica does not like, your pain will soon let you know about it. On the other hand, if it is a position which is better for you, your pain will be reduced and a better night's sleep will result.

It is important I finish this article by reinforcing that which I mentioned at the very top, it is not just the sleeping position which may be influencing your quality of sleep, but also what you have been doing the few hours before you go to bed as well. If you are performing certain aggravating activities or adopting poor postures for your low back pain or sciatica the few hours before retiring to bed, this will undoubtedly unsettle your pain and consequently interfere with your sleep and/or make your back stiff and sore in the morning. The important thing therefore is to be able to identify those activities which may potentially aggravate your pain and act accordingly.


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