Chronic low back pain is a debilitating condition that affects individuals from all walks of life. Sciatica and chronic low back pain (LBP) often get used interchangeably.
However, low back pain is only limited to the back. On the other hand, sciatica is inflammation of the sciatic nerve that can innervate the lower back, buttocks, legs, and feet.
Persistent, gnawing backache keeps you from sleeping peacefully. Sciatic nerve inflammation can make you restless, resulting in sleepless nights.
So, if you are searching (with half-open sleep-deprived eyes) for how to sleep with lower back pain, you have landed at the right spot.
We shall discuss the most potent sleeping tips and inform you about the best sleeping positions for low back pain and sciatica for restful, restorative sleep!
What Is Sciatica?
Low back pain can be the outcome of a musculoskeletal disorder, but in most cases, sciatic nerve inflammation is the culprit. According to a study, the annual incidence of sciatica was 1 to 5%. The painful condition is chronic and is more common in middle-aged individuals.
People with a prior sciatica episode are more prone to developing symptoms during physical activity. The symptoms of sciatica vary between individuals; however, most people experience the following symptoms:
- Sharp, electric pain that radiates from the lower back to the buttocks or the legs
- Difficulty walking, sitting, or standing (depending on the spinal region involved)
- Burning or tingling sensation in the legs
- Numbness of the back, leg, or feet
- Kinesiophobia (the fear of movement)
An occupational predisposition towards sciatica is also present. Truck drivers and machine operators who work in abnormal postures or experience constant bending of their spines are more prone to developing sciatica.
The younger generation is also making itself prone to spinal issues by persistently slouching over their phones. Poor postures contribute to the development of sciatica and low back pain.
What Causes Low Back Pain and Sciatica?
Several conditions can sprout pain in your back. The most common causes of sciatica and low back pain include:
- Trauma/injury to the lumbar spine
- Disc herniation or bulging
- Persistent abnormal posture (slouching)
- Compressions of the sciatic nerve
- Lumbar spine stenosis (narrowing of spinal spaces that compresses the nearby nerves)
- Piriformis syndrome (a disorder of the piriformis muscle in the lower back)
Every patient has a different story for the underlying cause that initiated inflammation of the sciatic nerve. Whatever the cause, the nerve symptoms are more or less the same.
Low Back Pain and Sciatica Affect Sleep
Chronic low back pain and sciatica can significantly interfere with work activity and physical well-being. According to a study, sciatica is a major cause of work leaves. The bothersomeness index of sciatica is high, and most people cannot return to work even after two years of treatment.
Sleep is an essential, passive activity required for the proper functioning, healing, and repair of all organs and tissues of the body. Continuous gnawing pain gravely affects the sleep quality and quantity of those with sciatica and lower back pain.
Around 80% of neuropathic pain patients have poor sleep quality. A meta-analysis suggests that sleep quality is directly linked to pain intensity. The higher the pain, the poorer the sleep quality.
The sleep quality in sciatica patients gets so compromised that studies take sleep disturbance as a parameter to measure the outcome of backache treatment. It is essential to correct sleep disturbances in sciatica patients because they can lead to an increase in pain sensitivity.
Symptoms of lower back pain and sciatica, like a throbbing and tingling sensation in the back or legs, often flare up at night. Lying down exerts pressure on the irritated spinal nerve, making it almost impossible to fall asleep.
Tips and Tricks to Improve Sleep Quality
If you are wondering how to sleep with lower back pain and sciatica, adopting some simple tips and tricks can help give you sciatica pain relief and good sleep through the night. They are as follows:
Carry Out Light Stretches Before Going to Sleep
Light stretching of the legs and back can help alleviate your symptoms. Plenty of sciatica stretches can help ease the nerve by relieving the pressure before going to sleep.
Some of these stretches require you to lie straight on a bed; thus, stretches before sleep time are convenient and successful.
Be sure not to overdo it and push your body too hard! A muscle stretch must relieve the pain and not cause it. Immediately stop stretching if it aggravates the pain. Below is a list of some very effective moves for sciatic nerve pain.o
- Knees to chest stretch
- Knee to the opposite shoulder stretch
- Seated hip stretch
Invest In the Right Mattress
Investing in a good mattress can be especially beneficial in decreasing sciatica and lower back pain. While your mattress might not be the root cause of the condition, it could cause it to get worse. The low back pain will increase if your spine (and associated nerves) stays in an abnormal position during the night.
In general, soft foam mattresses quickly lose their shape and the ability to keep your spine in the normal position. Therefore, chronic low back pain patients should buy a medium-firm mattress.
A firm or medium-firm mattress provides sufficient support to the cervical and the lumbar spine, thus protecting you from further sciatica pain and stiffness. The proper spine alignment takes the pressure off the nerve and reduces symptoms.
You can also find mattresses specially designed for spine patients. These mattresses correctly align your spine and help with low back pain. A self-adjustable mattress can also be beneficial.
Use an Extra Pillow
Sleeping with sciatica and low back pain is about reducing the pressure off the impinged sciatic nerve. Back sleepers can place a pillow under the back to support the spine and maintain a neutral alignment.
You can also place a pillow under your knees while sleeping on your back to prevent your spine from arching excessively.
If you are a side sleeper, put a pillow between the knees to relieve pressure off the spine, hips, and pelvis.
Keep the Knees Elevated
People with distorted sleep due to low back pain can find help in elevating their knees while sleeping. Many people tend to sleep on their backs, so keeping the spine relaxed in this position is crucial.
The ideal way of sleeping with lower back pain is to slightly bend your knees and lift them by placing pillows underneath. You can continue adding pillows until you feel maximum comfort.
Relax the Mind and Body Before Sleep
Low back pain patients frequently report fatigue and stress. That adds fuel to the fire and pushes you to the brink of sleeplessness. Adopting yoga and meditation can help you sleep better.
Studies show that yoga causes significant improvement in sciatica patients. It cuts down depressive symptoms and has shown promising results in managing sleep disorders.
Practicing yoga, meditation, and taichi before sleeping can relax your mind and body. That can, in turn, allow you to have a peaceful and pain-free sleep.
Use Ice/ Cold or Hot Therapy
Simple home treatments like heat or ice application can bring pain relief from sciatica. Irritation of the sciatic nerve responds differently to temperature changes. Some patients report a reduction in symptoms on the cold application, while others find relief in the hot application. Both strategies work for different underlying causes of sciatica and low back pain.
Cryotherapy seems to work better for trauma-induced sciatica patients. In cases of spinal injury, sciatic nerve impingement is majorly due to the inflammatory response of the nearby hard and soft tissues. Applying cold to the sore, painful site removes inflammatory cells from the site and brings about pain relief.
Heat application is helpful for musculoskeletal disorders. Patients suffering from piriformis syndrome can reduce pain by placing a hot towel or heat pack over the painful back.
Therefore, applying hot or cold before sleep may be a beneficial step!
Take Help From Medicines
Doctors typically prescribe non-steroidal anti-inflammatory drugs (NSAIDs) to counter inflammation and reduce pain. Specific nerve-acting drugs such as pregabalin and gabapentin may also be a part of the regimen.
You must take the prescribed medicines at the right time to sleep better with sciatica. A dose right before you doze can help reduce low back pain symptoms at night.
Take Turmeric Milk Before Bed
Turmeric is widely known for its exceptional anti-inflammatory properties. The active ingredient in the herb, curcumin, is very potent in reducing inflammation. Therefore, it frequently gets used as a home remedy for managing sciatic nerve pain.
Therefore, turmeric milk at night can add peace and comfort to your night's sleep.
Take a Warm Bath Before Bed
A warm bath helps soothe and relax sore muscles by reducing inflammation and increasing circulation. Thus, taking a warm bath before sleeping can bring pain relief from sciatica.
Sleeping Postures/ Positions for Low Back Pain and Sciatica
When discussing how to sleep with lower back pain and sciatica, it is crucial to know that the sleeping position can play a vital role in pain relief. Chronic low back pain patients usually figure out their ideal sleeping position with time. Choosing the best sleeping position for yourself is about trial and error until you find which provides maximum pain relief.
The following are some sleeping positions for lower back pain and sciatica:
On the Side
Sleeping on the side with the painful side on top is the best as it does not compress the nerves, relieving the tension from the spine and irritated sciatic nerve.
After getting in position with your knees bent slightly towards the chest at 90 degrees, place a pillow (medium-sized) between your knees. That maintains the normal positioning of the spine and pelvis.
Placing a pillow between the legs may abnormally raise the waist. For this, you can place a small pillow under the waist too.
On the Back
Obtaining sciatica pain relief can sometimes be as simple as sleeping with a neutral spine position.
To sleep on the back, place a pillow beneath your knees to evenly distribute the weight through the body while maintaining the spine’s natural alignment.
Keeping the neck in a neutral position is also critical. Your spine is interconnected, and any abnormality up the spine can trigger disturbances in the lower region as well.
The fetal position is similar to sleeping on your side, where you bring the knees up to the chest. This position creates the maximum space between your lumbar vertebrae and is most potent in relieving nerve pain. Several people find it to be most suitable for lower back pain symptoms.
Just make sure your posture doesn't restrict breathing!
Sleep on the Floor
Several patients prefer sleeping on the floor as it helps align their spine better than sleeping on soft surfaces. Place a thin mat on the floor for optimal comfort.
On the Stomach
When discussing how to sleep with sciatica and lower back pain, you’ll also want to know about certain sleeping positions to avoid.
Sleeping on the stomach is not recommended for low back pain and sciatica patients. It prevents you from maintaining your spine’s natural curvature as you might arch your back, leading to worsening symptoms.
This sleeping position can be slightly uncomfortable because you must turn your head to one side, which can strain the neck.
However, if you must sleep on your stomach, keep the head (turned on one side) on the pillow and try to keep the legs apart.
Widening the legs provides additional support to the back and helps alleviate pain. You can also put a pillow under the abdomen for better pressure relief.
Alternative Treatment Strategies for Sciatica/ Low Back Pain
In addition to sleeping positions, you can take help from non-interventional treatment strategies to manage sciatica. The most potent treatment modalities include:
Physical Therapy (PT)
A physiotherapy session can improve disability and alleviate pain in sciatica patients. Patients referred to physical therapy provide better outcomes. According to a randomized controlled trial, PT is effective in treating sciatica. Physical therapy not only reduces pain sensations but also helps in the management of kinesiophobia.
Traditional Chinese medicine (TCM) can help manage nerve disorders effectively. Low back pain and sciatica can be relieved using acupuncture (treatment by introducing fine needles into the skin).
According to a systematic review and meta-analysis, acupuncture works well in managing sciatica pain. A study found the treatment a safe and cost-effective modality for sciatica.