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Why Does Sciatica Get Worse at Night? Understanding the Night-time Struggle

If you suffer from sciatica, do you find it gets worse at night? 

Getting a good night’s sleep can be hard if you suffer from sciatic pain! Finding the right sleeping position… trying to get comfortable… The good news, however, is there are some things you can do to ease the ongoing nighttime struggle with discomfort!

In this article, we break down why sciatica can be particularly bothersome at night. We also share the best sleeping positions for sciatica and offer some handy management tips so you can get back to enjoying a good night’s sleep.

What Does Sciatica Feel Like?

The sciatic nerve (it’s the longest nerve in the human body) starts in your lower back. It then runs through your hips and buttocks and down each leg.

Sciatic pain most often feels like a sharp, shooting pain travelling along your sciatic nerve. People often describe it as feeling like an ‘electric shock’ or a burning sensation. It can also come with annoying tingling, numbness, or even muscle weakness. 

The pain can be constant or intermittent and varies from mild to excruciatingly painful. Some people find it difficult to move when the pain is intense. 

Why Does Sciatic Nerve Pain Get Worse at Night?

Why indeed! 

Normally we relax when we sleep, which often helps ease some types of painful conditions. Unfortunately, though, this isn’t always the case with sciatic pain, which does have a tendency to get worse at night. There are several key reasons for this.

Body Position: 

During the day, you spend a lot more time upright, which helps keep your spine in a neutral position. However, as soon as you lie down, your body weight distribution changes. Depending on your position, this can increase pressure on the sciatic nerve. 

Your muscles also tend to relax when you’re lying down, which can allow some vertebral shifting to occur. If this compresses your sciatic nerve, it will increase your pain. 

Hormone Fluctuations: 

Cortisol is an anti-inflammatory hormone produced by the adrenal glands. It naturally decreases at night during sleep, which can increase inflammation and pain sensitivity. This may in turn worsen sciatic pain.

Minimal Distractions: 

During the day, our minds are kept occupied, and distracted, by daily activities. At night, without this distraction, particularly if it’s quiet and still, your mind may focus on the pain so it feels more intense.

Lack of Movement: 

Regular movement helps keep blood flowing and can relieve pressure on the sciatic nerve. Conversely, lying down for long periods may increase nerve compression and sciatic pain.

What Are the Best Sleep Positions for Sciatica?

Some sleep positions are better for sciatica than others. Here are the ones we commonly recommend:

On Your Side

Sleeping on your side – particularly the side not affected by sciatica, can help reduce pressure on the sciatic nerve. Keeping your spine straight is also important as this minimises the risk of pinching the nerve. 

With a Pillow Between the Knees

Sleeping with a pillow between your knees can help reduce strain on your lower back and sciatic nerve as it keeps your hips, pelvis, and spine in better alignment.

In the Foetal Position

Curling into a foetal position i.e. with your knees up toward your chest, opens up the spaces between the vertebrae in your lower back. This helps reduce pressure on the sciatic nerve.

On Your Back with a Pillow Under the Knees

If you can sleep on your back, putting a pillow under your knees can help maintain the natural curve of your lower back to reduce pressure on the sciatic nerve. 

This sleeping position also helps distribute your weight more evenly across your body, which is why it’s generally considered the best sleeping position. 

With a Pillow Under the Lower Back

Placing a small pillow or rolled-up towel under your lower back while lying on your back can provide extra support and reduce nerve irritation. 

Tips To Relieve Sciatic Pain When Sleeping

In addition to the right sleeping position, the following can also help manage sciatic pain at night:

Avoid Soft Mattresses

Soft mattresses might envelope you in downy comfort but they also encourage your body to sink. This can misalign your spine, increase pressure on the sciatic nerve, and intensify sciatic pain during the night.

Try A Medium to Firm Mattress

A medium to firm mattress provides better support for your spine and helps keep it aligned to reduce nerve compression. You may in fact be pleasantly surprised at the difference it can make.

Put Plywood Under Your Mattress 

Good quality mattresses are expensive so if replacing your current one isn’t an option, a sheet of plywood underneath can add firmness and provide better support for your back.

Consider A Body Pillow

Body pillows are long cylindrical pillows specially designed to provide additional body support, in this case for your spine and hips. If you sleep on your side, place one between your knees or hug your chest to help maintain correct alignment. 

Consider Stretching or Yoga

Gentle stretching or yoga before bed is a very good way to relieve tension in your lower back and hips to reduce pressure on the sciatic nerve. In particular, focus on stretches that target the hamstrings, hips, and lower back.

Take A Warm Bath

A warm bath or shower just before bed is good for relaxing tight muscles and improving blood flow. The heat can also help reduce inflammation and make it easier to fall asleep. 

Follow Good Sleep Hygiene 

Good sleep hygiene is important and can greatly improve sleep quality. This includes things like establishing a regular sleep schedule, keeping your bedroom dark and cool, and avoiding computer or phone screens before bed. Good quality sleep in turn makes it easier to manage pain. 

When To Seek Medical Attention

Although sciatica can often be managed with lifestyle changes, there are times when medical attention is necessary. This is particularly the case if your pain is severe and persistent, or you have other symptoms.

In these instances, you should seek medical advice immediately as some symptoms can be indicative of a more serious condition. 

Conclusion: Why Is Sciatica Worse at Night?

Sciatic pain can be worse at night for various reasons, notably body position, hormonal changes, and reduced movement. 

However, if you work out the right sleep positions and take advantage of the tips we’ve provided to improve your sleep hygiene and make other recommended lifestyle adjustments, it is possible to manage your night-time sciatica discomfort effectively.

Gerard Haughey

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