This article was written by Dr. Babar Naeem (MBBS, MRCPCH) – a licensed and practicing medical doctor – to ensure maximum factual accuracy and unique content.
I’m currently writing this whilst in agony.
I pulled my lower back at the gym yesterday and now I can barely walk due to the muscles in my lower back seizing up in spasms – plus I have a burning and itching pain that radiates from my lower back down my legs due to sciatic nerve irritation.
Lower back pain and sciatic pain can be worse at night due to lying down – causing more pressure on the sciatic nerve, spine, muscles, and joints.
This can make getting to sleep very difficult – as I discovered last night.
So what’s the best way to get to sleep with lower back pain and sciatica?
The most effective way to sleep better with lower back pain and sciatica is to elevate the upper and lower portions of an adjustable bed to distribute your weight more comfortably. Sleeping on your side, taking painkillers, and applying heat patches can also reduce pain.
The rest of this article expands upon these points to give you 21 actionable ways to help you sleep better with lower back pain and sciatica.
This article was written by a qualified and practicing medical doctor to provide you with the most accurate and reliable information.
But you should always consult with your own doctor to get the best treatment and care for your condition.
21 Ways to Sleep with Lower Back Pain and Sciatica
Here are 21 different techniques to help you sleep better with lower back pain and sciatica now:
1: Sleep On an Adjustable Bed to Reduce Discomfort
Sleeping on an adjustable bed is an effective way to reduce the discomfort of lower back pain and sciatica at night because you can adjust the angle of the bed to shift the weight away from the regions that are causing you pain.
For example, elevating the upper and lower portions of the bed can create a ‘zero gravity’ position that can help take the pressure off your lower back and legs for instant relief.
An adjustable bed is an excellent long-term investment if you have chronic lower back pain and sciatica, whilst also potentially providing relief from snoring, sleep apnea, COPD, and acid reflux.
2: Take Doctor Prescribed Pain Medications for Acute Relief
Taking a long-acting analgesic or anti-inflammatory medication like paracetamol or ibuprofen is an effective way to reduce the discomfort of lower back pain and sciatica at night so that you can get to sleep.
If you have consulted a doctor and have a prescription for pain medications then you should use these as prescribed.
However, taking pain medications long-term can be harmful to your health so it’s important that you consult with your doctor to treat the underlying cause of your condition for more effective relief.
3: Sleep On Your Side With Your Knees Slightly Bent
What is the best sleeping position if you have lower back pain and sciatica?
The best sleeping position for individuals with lower back pain and sciatica is on your side with your knees slightly bent – putting a small cushion or pillow between your knees is also helpful in order to decrease the pressure on your spine .
If you are unable to sleep on your side then you can do the following to improve your posture:
- Place a cushion under the legs, knees, and lower back to support the spine.
- Use an adjustable bed and raise the lower portion of the bed to minimize tension on your back.
- If you are a habitual stomach sleeper then place a cushion under your hips and belly.
4: Choose a Mattress With the Right Firmness for You
A study published in ScienceDirect stated that a medium-firm mattress can alleviate musculoskeletal pain and improve sleep .
However, having suffered from back pain myself and tested many different mattresses over the years, I can tell you from experience that the truth is less black and white.
The best mattress firmness to reduce lower back pain and sciatica is the one that best suits your dominant sleeping position, body type, and bodyweight – this means that there is no single proven level of mattress firmness to treat back pain and sciatica.
But based on my many years as a professional mattress tester, I can tell you that the following mattress firmnesses generally map favorably to the following sleeping requirements and may help to reduce the discomfort of lower back pain and sciatica:
- Firm – firmer mattresses tend to be better for heavier weighted front and back sleepers over 200 lbs with lower back pain and sciatica because they can help to keep you in good posture.
- Medium – medium firmness mattresses can be ideal for front, back and side sleepers with lower back pain and sciatica in the 150 – 200 lbs range because they offer a good balance of pressure relief and support.
- Soft – softer mattresses are better suited to side and lighter weighted sleepers under 150 lbs with lower back pain and sciatica because the softer surface allows for more pressure relief and more even weight distribution to remove the pressure in your joints.
Hybrid Memory Foam and Hybrid Latex Foam Mattresses Can Help Reduce Pain
In addition to choosing the best level of firmness for your sleeping style, you’ll want to consider what the mattress is made out of in order to get the most pain relief.
Hybrid mattresses that have a pocket coil support core and either a memory foam or latex foam comfort layer are the best types of mattresses for alleviating the discomfort of lower back pain and sciatica because they help to keep you in good posture whilst also taking away the pressure on your sciatic nerve.
You should also consider pairing the mattress with an adjustable bed frame to enhance the comfort even more – here are two of my top mattress recommendations that also work with adjustable frames:
- I recommend the Puffy Lux Hybrid if you are a side sleeper under 230 lbs with lower back pain and sciatica due to the excellent pressure relief it provides – click here to learn more.
- If you are a heavier weighted back or front sleeper over 200 lbs I recommend the DreamCloud mattress because it has excellent adaptive support – click here to see my personal review.
5: Choose the Correct Pillow Loft to Reduce Strain
A 2014 study revealed that the shape and content of a pillow play a very important role in maintaining the curvature of the spine and quality of sleep .
This means that you should choose a pillow loft (thickness) that suits your sleeping style as follows:
- If you are a side sleeper then you will need a thicker pillow to accommodate your shoulders – a loft height of 5-7 inches is generally ideal.
- If you are a back sleeper then a thinner pillow with a loft of 4-6 inches can help to keep you in good posture and reduce back and neck pain.
6: Maintain Good Posture During the Day
A common trigger of back pain and sciatica is incorrect posture and lifting heavy weights during the day because it stresses the lower back and can put pressure on the sciatic nerve.
If the posture is not corrected, the condition will only worsen.
Examples of harmful incorrect postures include:
- Lifting a heavy weight by bending at the lower back.
- Leaning forward into the computer while working.
- Standing with your body weight shifted on one leg.
- Lying on your stomach while reading.
How to Correct Your Posture
Incorrect posture puts stress on the spine and damages the bones, muscles, and vertebral discs.
If bad posture is corrected, most of the problems can be solved.
I have compiled a list of easy-to-follow tips to help you correct your posture:
- Keep your back, shoulders, and head straight and level while walking.
- When you are working at a desk, it is very important to keep your back straight.
- Place a pillow or towel behind your lower back when sitting.
- Avoid weights that are too heavy.
- If it is necessary to lift a heavy object, then you should hold it close to your body and maintain a straight posture – bend at the knees rather than the waist.
- Do not wear high heels.
- Avoid standing in the same position for too long.
7: Get Massage Therapy from a Physiotherapist
Massage therapy can provide many benefits to patients with back pain or sciatica.
A gentle massage improves blood circulation in the affected area, decreases muscle tension, reduces pressure on the nerves, and increases the range of movement .
Massage therapy for sciatica should be performed by a trained physiotherapist.
8: Use a Pain-Relief or Capsaicin Patch at Bedtime
Capsaicin and other pain-relief patches are a very effective yet underused method of pain management.
These patches deliver the drug directly to the affected area – whilst most of the side effects are avoided.
Most patches provide pain relief for around 8-12 hours, so good quality sleep is also possible if they are applied at bedtime.
Several studies have confirmed the safety and efficacy of these patches for the management of pain and sleep , .
Here’s how to use these patches to help reduce your lower back and sciatic pain:
- The patch should be applied on unbroken and intact skin only.
- The skin should be clean and dry before applying the patch.
- A patch should not be left in place for a prolonged period, as it can cause irritation and discomfort.
- Avoid exposure to direct sunlight, hot baths, and showers for 24-48 hours.
- After treatment, remove the patch carefully, wash the area and then let it air-dry.
- Consult your doctor immediately if there are concerns over adverse side effects.
9: Sleep On the Less Painful Side
Although the best sleeping posture is lying on your back, it often becomes very difficult for a person with back pain to find a single position comfortable.
So if you cannot sleep on your back and have pain on one side, then you should always try to sleep with the affected side upwards in order to reduce pressure.
10: Apply Kinesiology Tape (KT) at Night for Support
If kinesiology tape is applied, it can provide pain relief throughout the night and help you to sleep better.
The tape is a newly popular and specific method of treatment that is used to improve mobility and support joints, muscles, and tendons.
It was developed by Dr. Kenzo Kase in 1973 and involves placing strips of tape in specific positions on your body.
KT is designed to mimic skin elasticity so it can be used in a full range of motion.
When applied correctly, it gently lifts the upper layer of the skin, creating a space between the skin and the underlying tissues.
This space relieves pressure on the lymphatic vessels and results in better lymph drainage.
It also improves the circulation of blood in the affected area.
How to Use Kinesiology Tape to Reduce Back Pain at Night
The video above shows you one way to use kinesiology tape to treat lower back pain.
Here are some more tips:
- The skin should be clean, without dirt, oil, or sweat before applying the KT.
- Kinesiology tape should not be applied for longer than 24 hours, as prolonged application can cause skin problems.
- Long hairs can hinder the proper application of the tape and should therefore be shaved before application.
- KT should be re-applied every day as the skin adapts to the stimulation created by the tape.
- The skin should not be stretched excessively before applying the KT.
- Vigorous rubbing of the tape must be avoided as it can cause skin irritation.
- Wait for at least 10 minutes before starting any activity so that your body can adapt to the taping.
- KT should not be applied to the abdomen immediately after eating as it can cause digestive problems.
- If you experience itching or any other undesirable side effect, KT should be removed immediately.
11: Use a TEN Device Before Sleeping
A Transcutaneous Electrical Nerve Stimulation (TENS) device delivers an electrical current to the affected nerves under the skin to provide pain relief.
It has small self-adhesive electrodes that are applied to the skin.
The patient can easily adjust the intensity and frequency of the electric current according to their needs.
The duration of pain relief is different for different people; some report that pain relief lasts for up to 24 hours after the device has been switched off .
12: Reduce Stress With Meditation, Breathing, and Exercise
Stress reduction is helpful for the treatment as well as for the prevention of back pain and sciatica.
Stress and anxiety are considered the root of many problems.
Stress triggers spasms and tension in the back muscles that result in back pain. If stress is not managed, the problem will only get worse.
A meta-analysis of different studies has confirmed the beneficial effects of mindfulness-based stress reduction on the pain intensity and physical functioning of patients with low-level back pain.
Some of the methods of stress reduction are:
Mindfulness is a technique where the patient is trained to be aware of their body.
There are different ways to achieve this.
Some experts recommend sitting quietly for up to 30 minutes and directing your attention in specific ways.
Mindfulness can also be applied to routine activities such as walking, eating, driving, or bathing .
There are many variations and different techniques used  – you can use the video above and/or follow these tips:
- Focus your attention on a particular activity such as breathing or walking and observe it carefully.
- Notice when your attention is diverted away into memories, thoughts, or fantasies.
- When this happens, take note that your mind has diverted and gently return to the target of attention.
- If emotions or other sensations arise, observe them and notice how they feel, where they arise and whether they are changing over time.
- Mentally label your observed experience using short phrases or words like ‘sadness’, ‘thinking’, ‘wanting to move’ etc.
- Use this meditation before going to bed to move your attention away from the painful sensation.
The body’s stress response can be decreased by taking deep breaths in and out for several minutes.
This is another method to reduce stress and anxiety:
- Contract your fist for ten seconds and then relax.
- Pay full attention to the contracting muscles.
- Always take a deep breath during contraction and relaxation.
- Now move on to the wrist muscles and repeat the same pattern of contraction and relaxation.
- This method should be repeated with different muscles of the body for thirty minutes.
13: Exercise Regularly to Release Muscular Tension
Regular exercise will strengthen your back muscles and keep them healthy.
This increases the blood supply to the heart, lungs, and the rest of the body.
Exercise relaxes tense and painful muscles and releases endorphins that are our body’s natural painkillers.
All of these factors will help alleviate pain and improve sleep.
Some important points to keep in mind while exercising are:
- Always start with short sessions of fifteen to twenty minutes.
- Gradually increase the duration of the exercise as your stamina builds.
- Always remember to regulate your breathing during the workout.
- Avoid lifting heavy weights.
- Be consistent: twenty to thirty minutes every day is much more effective than doing a 4-hour session and then skipping the rest of the week.
14: Do Yoga or Stretching Before Bed to Lessen Pain
Strenuous exercise before bed can interfere with your sleep and will do more harm than good.
However, simple stretches are very helpful in managing back pain and sciatica.
They increase blood flow to the back muscles and help to rehabilitate the injured tissue.
The video above takes you through a yoga sequence that helps to alleviate lower back and sciatic pain.
15: Lose Weight to Decrease the Load on Your Back and Legs
A balanced diet, maintaining a healthy weight, and not smoking can be very helpful in managing back pain and sciatica.
Environmental factors and our lifestyle choices play a very important role in the health of our spines.
Excessive weight, smoking, and an unhealthy diet put us at greater risk of developing back pain.
Therefore, the following healthy lifestyle changes can be made to relieve back pain:
- Every extra pound puts strain on the back and weakens our bones. This is like carrying extra weight around all the time. That’s why every effort should be made to maintain a healthy body weight. Even losing a small amount of weight can provide significant relief from back pain.
- Cigarette smoke contains nictoine that constricts blood vessels and decreases the blood flow and nutrients to the spine. This can result in an increased incidence of back pain and sciatica. Stopping smoking can reverse these changes and is very helpful for pain relief and healthy sleep.
- A balanced diet is essential for our overall health and proper spine function. A diet with a high proportion of fruits and vegetables is helpful in combating back pain.
16: Try Hot and Cold Therapy to Treat Pain
Hot and cold therapies are an effective way to treat back pain at home .
If the temperature of a small area of the body is lowered, this is known as cryotherapy or cold therapy.
If this occurs throughout the body it is called hypothermia, which may be harmful to the body.
Studies have established the effectiveness of cryotherapy for relieving back pain when used in combination with drugs.
It also decreases edema and inflammation at the site of the pain.
One way to provide cold therapy is through ice packs.
Ice cubes wrapped in a cloth or towel can be applied to the back to relieve pain.
Thermotherapy or heat therapy is the application of heat to treat back pain – it can be:
- Superficial (applied to the skin).
- Deep (used for muscles and joints).
Thermotherapy alleviates back pain by inhibiting the pain signal generated by the nerves.
Moreover, it increases the flexibility of the soft tissues, the resistance of the muscles, and aids the smooth contraction of the muscles.
Thermotherapy can be applied via a hot water bottle or special heating pads.
I always recommend using cold and heat therapies carefully as they can burn the skin if applied for a longer period.
Moderation is always the key; you should avoid a temperature that is either too hot or too cold.
The therapy should be discontinued if you feel any pain or discomfort.
17: Take a Warm Bath Before Bed to Relax
A warm bath before bed provides a soothing effect and aids sleep.
Warm water has a relaxing and healing effect for any injured tissue.
It increases the temperature of the muscles and stimulates blood flow around injured tissue.
It also relieves muscle spasms and promotes healing.
Various studies have confirmed the beneficial effect of a warm bath on the onset of sleep.
Please remember that using water that is too hot can have the opposite effect as it can burn the skin .
18: Avoid Caffeine in the Evening
To have a good quality sleep, you should avoid taking caffeine in the evening and at bedtime.
Caffeine is one of the most commonly used stimulants and is found in coffee, tea, and energy drinks.
According to a study, around 90% of adults in the United States consume caffeinated beverages.
It has the potential to enhance performance but can also cause anxiety, insomnia, waking up frequently during the night, and poor sleep quality.
Sudden withdrawal from caffeine can also cause poor cognitive, behavioral, and emotional function.
I recommend my patients avoid ingesting caffeine for at least 6 hours before going to bed.
19: Follow Sleep Hygiene Recommendations
Sleep hygiene is also required to have a good quality sleep under any condition.
I have always stressed the importance of sleep hygiene along with other therapies.
The important recommendations are summarized below:
- Set a fixed time for going to bed and waking up.
- Create an environment that is calm and peaceful.
- Don’t use the bedroom for television or other purposes.
- Dim the light before going to bed.
- The bedroom should be noise-free.
- Wear comfortable clothing.
- A slightly cooler environment aids falling asleep.
- Don’t eat a heavy meal before going to bed.
- Choose a comfortable sleeping position.
- Don’t change your sleeping schedule, even at the weekend.
- Don’t use sleeping pills.
- Don’t nap during the day.
20: Avoid Electronic Devices 2-3 Hours Before Bed Time
The use of electronic devices is associated with poor quality sleep.
Electronic devices like mobiles, computers, laptops, etc. have become an important part of our lives but they can interfere with our sleep through various mechanisms:
- The use of these devices suppresses the production of melatonin, a natural hormone produced in our body that initiates sleep.
- They disrupt our sleep/wake up cycle.
- Psychological and emotional factors triggered by using these devices result in the release of adrenaline that further delays the onset of sleep.
I recommend avoiding smartphones, laptops, and other electronic devices in the bedroom.
21: Discuss Surgical Options to Cure Sciatic Pain Permanently
Sciatica is caused by the compression or irritation of the sciatic nerve.
Surgery is one option that can remove the root cause of the compression and irritation (called surgical decompression).
Various surgical options are available to relieve the pressure on the sciatic nerve.
Surgical decompression is not as simple as it sounds and can have various risks and complications, for example:
- Nerve damage.
- Blood clots.
- Spinal fluid leakage.
- Complications due to anesthesia.
This is why surgery is reserved for cases with severe pain that does not respond to other treatment options, the involvement of bowel and bladder problems, or the development of foot drop.
Always discuss the benefits and risks of surgery in detail with your doctor and carefully consider whether the benefits outweigh the risks before opting for surgery.
Conclusion: Start With Postural Changes
The most effective way to begin treating lower back and sciatic pain at night is to change your posture to shift the weight away from the painful trigger points on your body.
Try sleeping on your side with a pillow between your knees and/or increasing the angle of your sleep surface using an adjustable bed to aleviate the pressure.
If in doubt, talk to your doctor first.
Sources and References
1: Low Back Pain, available at https://familydoctor.org/condition/low-back-pain/
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3: Jeon, M. Y., Jeong, H., Lee, S., Choi, W., Park, J. H., Tak, S. J., Choi, D. H., & Yim, J. (2014). Improving the quality of sleep with an optimal pillow: a randomized, comparative study. The Tohoku journal of experimental medicine, 233(3), 183–188. https://doi.org/10.1620/tjem.233.183
4: Bell J. (2008). Massage therapy helps to increase range of motion, decrease pain and assist in healing a client with low back pain and sciatica symptoms. Journal of bodywork and movement therapies, 12(3), 281–289. https://doi.org/10.1016/j.jbmt.2008.01.006
5: Gudin, J. A., Dietze, D. T., & Hurwitz, P. L. (2020). Improvement of Pain and Function After Use of a Topical Pain Relieving Patch: Results of the RELIEF Study. Journal of pain research, 13, 1557–1568. https://doi.org/10.2147/JPR.S258883
6: Moon, J. Y., Lee, P. B., Kim, Y. C., Lee, S. C., Nahm, F. S., & Choi, E. (2017). Efficacy and Safety of 0.625% and 1.25% Capsaicin Patch in Peripheral Neuropathic Pain: Multi-Center, Randomized, and Semi-Double Blind Controlled Study. Pain physician, 20(2), 27–35.
7: Johnson, M. I., Jones, G., Paley, C. A., & Wittkopf, P. G. (2019). The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs). BMJ open, 9(10), e029999. https://doi.org/10.1136/bmjopen-2019-029999
8: Anheyer, D., Haller, H., Barth, J., Lauche, R., Dobos, G., & Cramer, H. (2017). Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Annals of internal medicine, 166(11), 799–807. https://doi.org/10.7326/M16-1997
9: Baer R, Krietemeyer J. In: Mindfulness Based Treatment Approaches; Clinician’s Guide to Evidence Base and Applications. Baer R, Burlington MA, editor. Elsevier Academic Press; 2006. Overview of mindfulness and acceptance based treatment approaches; pp. 3–27.
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11: Behrend, C., Prasarn, M., Coyne, E., Horodyski, M., Wright, J., & Rechtine, G. R. (2012). Smoking Cessation Related to Improved Patient-Reported Pain Scores Following Spinal Care. The Journal of bone and joint surgery. American volume, 94(23), 2161–2166. https://doi.org/10.2106/JBJS.K.01598
12: Dehghan, M., & Farahbod, F. (2014). The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study. Journal of clinical and diagnostic research : JCDR, 8(9), LC01–LC4. https://doi.org/10.7860/JCDR/2014/7404.4818
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14: He, J., Wu, B., Jiang, X. et al. A new analgesic method, two-minute sciatic nerve press, for immediate pain relief: a randomized trial. BMC Anesthesiol 8, 1 (2008). https://doi.org/10.1186/1471-2253-8-1
No part of this article or website offers medical advice – consult with a qualified medical professional for the best guidance.
Image Attribution and Licencing
Main image: ‘Pain in the Spine’ by Staras (Getty Images) used with permission under the terms of Canva’s One Design Use License Agreement.
Dan is the founder and head content creator at Bedroom Style Reviews.
He has been working as a professional online product reviewer since 2015 and was inspired to start this website when he ended up sleeping on a memory foam mattress that was too soft and gave him backache.
Through in-depth research and analysis, Dan’s goal with this website is to help others avoid such pitfalls by creating the best online resource for helping you find your ideal mattress, bedding, and bedroom furniture.
Dan is a qualified NVQ Level 2 Fitness Instructor with 6 years’ experience helping clients improve their health through diet, exercise, and proper sleep hygiene.
He also holds several college and university-level qualifications in health sciences, psychology, mathematics, art, and digital media creation – which helps him to publish well researched and informative product reviews as well as articles on sleep, health, wellbeing, and home decor.
Dan also has direct personal experience with insomnia, anxiety, misophonia (hypersensitivity to sounds), and pain from both acute and long-standing sporting injuries – he enjoys writing insightful articles around these subjects to help fellow sufferers of such conditions.
Learn more about Dan here.