Do you have sciatica, or are you looking to prevent its onset, and have questions about which positions to avoid or favor to relieve pain or prevent its worsening? During yoga poses, exercice or at work?
As a physiotherapist, I summarize our current knowledge on the subject based on my professional experience, feedback from my patients, and my research in international medical publications. I address the most common questions from my patients and online users.
You will find at the end of the article all the references to the cited studies, as well as a comment section for any remarks or questions!
This information applies regardless of the underlying cause of your sciatica (herniated disc, osteoarthritis, etc.) and the affected nerve territory (L4, L5, S1, S2, and S3).
- No position is “forbidden” or “absolutely to be avoided” because none structurally worsens the underlying problem causing the pain, as we never maintain the same position 24/7.
- Some positions provide more relief to individuals than others, but they are not the same for everyone.
- These positions, whether relieving or not, do not have a significant impact on therecovery time of the sciatica episode.
Happy reading 🙂!
Last update: October 2023
Disclaimer: Affiliate links. Complete disclosure in legal notices. Written by Nelly Darbois, physical therapist and scientific writer
Why this article focusing on positions to avoid in the case of sciatica?
If you have sciatica, there is a very high probability that you are questioning which positions to avoid (or conversely, to adopt) in order to:
- relieve the pain;
- prevent the worsening of sciatic nerve irritation or compression;
- shorten the duration of the sciatica episode.
My patients who experience an acute episode of lsciatica almost always ask me this question. And you are among thousands of internet users each month who pose this question in your search engine:
The articles that come up when you enter keywords like “sciatica and yoga poses to avoid” in Google or YouTube search typically lead to content that does not rely on existing empirical data on the subject.
Sometimes, you may even find contradictory or incorrect information.
I hope to answer your questions in the most reliable and accurate way possible with this article! So you can be less confused when confronted with potentially conflicting information and choose what seems most coherent and suitable for your situation.
Is there really a position to avoid in the case of sciatica?
Whether you have back pain, pain in the buttock, thigh, leg, and foot related to your sciatica, there is no position that is strictly forbidden.
No position, even if maintained for several hours a day, is likely to:
- worsen any structural problem causing sciatica;
- prolong the duration of the sciatica episode.
What makes things confusing is that there are indeed positions that are more “restrictive” or “demanding” on the sciatic nerve. They increase pressure on the intervertebral discs, which can increase compression on the sciatic nerve.
But this remains very theoretical, and it is reasonable to think that it does not significantly lengthen the duration or intensity of symptoms. Since most people cannot stay static in the same position for hours anyway: we move reflexively when we feel too much strain (except in special cases: quadriplegic or others).
Advice on positions to avoid in the case of sciatica is based on anatomical principles and clinical experience. No study shows that people who take certain positions during the day have more pain than others or take longer to recover from sciatica.
What position makes sciatica worse?
You may have noticed for yourself that certain positions either increase or relieve your pain, at least for a few minutes while you adopt them.
However, these pain-relieving positions for sciatica vary greatly from person to person. With my patients who request it, we try to identify positions that are most likely to relieve their symptoms.
But the goal is not to treat sciatica or speed up recovery; it’s simply to make the symptoms a bit more bearable.
I know it’s frustrating, and we’d all like to find THE yoga pose or exercise that will make sciatica pain go away in a flash or in a few days. Unfortunately, things don’t work that way.
For many people, sciatica lasts only a few days or a few weeks, but this is independent of the postures or positions they adopt.
Painful sitting position in cases of sciatica
The sitting position can compress the sciatic nerve (and be painful) due to several biomechanical factors:
- The lumbar spine tends to flex forward. This flexion can bring the lumbar vertebrae closer together and increase pressure on the intervertebral discs. Disc compression can exert pressure on the sciatic nerve, causing sciatica symptoms.
- Pressure on surrounding tissues such as muscles, tendons, and ligaments may increase. This can lead to direct or indirect compression of the sciatic nerve, generating symptoms.
- Pinching of the nerve in the piriformis muscle: the sciatic nerve passes through or under the piriformis muscle located in the buttock region. In some people, the piriformis muscle may be tight or spasmodic, which can cause compression or pinching of the sciatic nerve when sitting.
- Some people may experience an aggravation of sciatica symptoms when sitting,
- While others may find relief only when sitting!
Individual factors can influence how the sitting position affects the sciatic nerve. That’s why the sitting position is not “forbidden” or “to be avoided” in cases of sciatica.
Sciatic nerve pain when lying down
Similarly, for some people, it’s the lying down position that can worsen or accentuate sciatica symptoms. This can happen for at least these two reasons:
- The lumbar spine can extend during lying down. This extension can lead to increased pressure on the intervertebral discs, which can compress the sciatic nerve and cause sciatica symptoms.
- Some muscles in the lower back may contract or stiffen, which can exert additional pressure on the lumbar region and the sciatic nerve.
Again, there is no connection between the duration you spend lying down (compared to sitting) and the duration of the sciatica episode.
Simply limit the painful lying-down position if you find other positions more comfortable, but only for the purpose of relieving yourself in the moment.
Sexual positions to avoid?
Many internet users wonder if there are sexual positions to avoid during a sciatica episode. Regardless of the activities you engage in, the reasoning is always the same:
- There is no position that significantly increases the recovery time of your sciatica.
- Some positions can increase pain at the moment, but they vary greatly among individuals.
- If you experience pain in a position, regardless of the position, you can change your position to relieve pain or discomfort at the moment.
What is the best position to rest sciatic pain?
In the case of sciatica, the reasoning remains the same for movements and postures to avoid and those to encourage: these movements are unique to each individual.
No adopted position will significantly reduce the duration of sciatica.
Moderate-quality evidence shows that people suffering from acute sciatica may benefit from mild pain relief and functional improvement when advised to stay active rather than rest in bed, but less than those with just back pain (Cochrane, 2010). Regardless of the positions adopted!
Position to relieve sciatica during the day
Here are some positions that relieve pain in people with sciatica. These same positions can increase pain in some individuals! It’s only through testing that you can know:
- Semi-reclined position on a comfortable armchair or propped up with cushions.
- Lying on a memory foam mattress with the back slightly elevated.
- Lying on the couch.
- Sitting with elbows resting on armrests or a table, with feet elevated.
- Sphinx pose: lying on the stomach, using hands to lift the torso.
- Yoga poses: pigeon pose, cobra pose, etc.
What is the best sleeping position to relieve sciatica?
It’s up to you to find the position in which you are most comfortable sleeping during sciatica. Some people like:
- Using a body pillow/nursing pillow, as used by pregnant women and then new mothers.
- Sleeping on the side with a pillow between the legs or in the fetal position.
- Sleeping on the back with a pillow under the legs.
- Sleeping on the stomach with one leg bent.
Can you sleep on your stomach with sciatica?
There is absolutely no contraindication to sleeping on your stomach with sciatica. Some people will find relief in this position, while others may be less comfortable; in that case, simply change position.
Is there a specific pillow for sleeping with sciatica?
Any type of pillow or body pillow you have at home can work. Here are a pillow commonly used for sciatica to help find a better sleeping position:
⭐⭐⭐⭐ 86,585 reviews – 4,3/5
Why does sciatica hurt more at night?
Sciatica can indeed feel more intense at night for some people. Here are several factors that can contribute to this sensation:
- Some hormones, such as cortisol, can influence pain perception. Cortisol levels are typically lower at night, which can make sciatica pain sharper.
- During the day, when you are active, your muscles are engaged and support the spine. During sleep, muscles are more relaxed, which can increase nerve tension and intensify sciatica pain.
- Underlying conditions like a herniated disc or spinal stenosis can cause inflammation around the spinal nerves. Inflammation tends to be more active at night.
- Anxiety and stress can influence pain perception. At night, when you are calmer and have fewer distractions, you may be more attentive to sciatica pain, making it feel more intense.
Work restrictions for sciatica?
Work restrictions for sciatica can vary depending on the nature of your job, the severity of your symptoms, and how they impact your ability to perform your tasks effectively. Here are some considerations:
- Nature of Your Job: If your profession requires you to perform specific movements or tasks that exacerbate your sciatica symptoms, you may need to be on sick leave. For example, if you have a physically demanding job that involves heavy lifting, repetitive bending, or prolonged periods of standing, and these activities worsen your condition, your doctor may recommend work restrictions.
- Difficulty with Heavy Lifting: Many people with sciatica find it challenging to lift heavy objects. If your job involves frequent heavy lifting, it could be detrimental to your condition.
- Otherwise, it’s similar to your daily life. There are no positions that must be completely avoided with sciatica, but simply adapt as needed.
What is the “best” position when you have sciatica?
If I’ve managed to be clear enough throughout this article, by this point, you should have understood that there is no wrong posture or position when it comes to sciatica.
No position is likely to prolong your sciatica episode. Conversely, no position can reliably shorten the duration of your sciatica.
However, some positions may be more comfortable than others. It’s up to you to test them, possibly with the help of a professional if you feel the need for guidance in this regard.
Even though you may have some apprehension about trying new positions, keep in mind that you won’t suddenly “break” or “compress” something. Some positions (without being able to predict which ones in advance) may temporarily increase your pain, but it’s only temporary.
It is reasonable to believe that movement, walking, is a good thing to relieve pain related to sciatica (wild animals don’t have chronic pain!), regardless of the precise nature of the movements.
Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !
If you feel the need to learn more about the recovery period, I wrote this guide in eBook format:
You may also like:
Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low‐back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No.: CD007612. DOI: 10.1002/14651858.CD007612.pub2. Accessed 18 May 2023.
Lelong et al. Biomécanique des disques lombaires et station assise de travail. Ann. Kin ésithér. , 1989, t. 16, nO 1-2, pp. 33-40. © Masson, Paris, 1989
Image : Scarcia L, Pileggi M, Camilli A, Romi A, Bartolo A, Giubbolini F, Valente I, Garignano G, D’Argento F, Pedicelli A, Alexandre AM. Degenerative Disc Disease of the Spine: From Anatomy to Pathophysiology and Radiological Appearance, with Morphological and Functional Considerations. J Pers Med. 2022 Nov 1;12(11):1810. doi: 10.3390/jpm12111810. PMID: 36579533; PMCID: PMC9698646.
Written by Nelly Darbois
I love writing articles based on my experience as a physiotherapist (since 2012), scientific writer, and extensive researcher in international scientific literature.
I live in the French Alps 🌞❄️, where I work as a scientific editor for my own website, which is where you are right now.