21 Tips For Sleeping With Sciatica From Your Physio

How do I sleep with sciatica? Are there certain positions to prefer or others to avoid? Should I change my bedding? Is an adapted cushion useful?

Every month, thousands of people consult their favorite search engine to find answers to these questions.

In this article, I try to answer them as comprehensively as possible, drawing on :

• my expertise as a physiotherapist reinforced by my eye as a researcher;
• an in-depth review of scientific studies on the subject.

Happy reading! 🙂

(Any questions, comments or experiences to share? Feel free to use the comments section at the end of the article! 🙏)

♻️ Last updated: March 2024. Written by Nelly Darbois, physiotherapist and scientific writer.
👨‍⚖️ Declaration of financial interests: Amazon affiliate links. My complete declaration of financial interests is available in the legal notice section.

To begin with: an important scientific truth

There are 3 basic sleepingpositions (in order of popularity):

1. on the side ;
2. on the back;
3. on the belly.

That said, there’s no good reason to think that sciatica should be avoided at all costs.

To put it another way, if you’ve read or heard somewhere that sleeping on your stomach is bad, you should know that this idea has no scientific basis whatsoever.

Practical consequences:

• in case of sciatica, don’t necessarily try to change your favorite sleeping position;
• Instead, let’s take a look at how to modify this position, so that the pain causes as little discomfort as possible when you fall asleep.

Sources: Skarpsno, 2017; Cary, 2019

6 general tips for all basic positions

Here are 6 general tips that can be used for all the tricks I present in the rest of this article:

1️⃣ Considerusing a rolled or foldedblanket or bath towel in place of a cushion.

In fact, many of the tricks I’m about to show you require the use of cushions in addition to your usual pillow.

Using a blanket or towel provides a more customizable support system than a typical cushion, in terms of shape and thickness.

2️⃣ If you use a cushion to cushion a part of your body, feel free to test different thicknesses of cushioning:

• or with several cushions;
• or by profiling the previous tip (use of blankets or towels).

3️⃣ If you need to position a limb in a certain way, for example, by bending the knee more or less, don’t hesitate to try out different angles of position.

By the way, if you’ve read somewhere that such and such a part of your body should be aligned or at right angles, you should know that this idea has no scientific basis whatsoever.

4️⃣ Consider investing in a positioning cushion.

This type of cushion can be a low-cost option for trying out new sleeping configurations. They’re highly malleable.

For those who like to sleep on their side, I’ll show you two ways of using this type of cushion below.

5️⃣ Don’t be afraid to combine different tips and tricks!

6️⃣ Feel free totry things other than those described in this article!

Contrary to what can be seen elsewhere on the web, the idea that there are forbidden or dangerous positions for sciatica has no scientific basis.

The best position is the one that suits you best. Bad positions are simply the ones that hurt the most.

Source: Cary, 2019

5 tips for sleeping ON YOUR BACK with sciatica

If you usually like to fall asleep on your back, here are 5 tricks to try to maintain your habit despite sciatica:

1️⃣ Place a cushion under both knees, so that they are more or less bent;

2️⃣ put a cushion only under the knee on the painful side;

3️⃣ place one or more large cushions under the legs to raise them completely (see image below);

4️⃣ use a large cushion or several cushions (or even a reclining bed);

5️⃣ Bend your knee (foot on mattress), then tip your leg to the side to rest it on a cushion (see image below).

5 tips for sleeping ON YOUR SIDE with sciatica

If you’re used to falling asleep on your side, here are 5 tips to help you maintain this position despite your sciatica:

1️⃣ adopt a fetal position (also known as the “gun dog” position; see image below); don’t hesitate to try different degrees of closure on yourself.

For the record, the idea that you should keep your spine perfectly aligned when you sleep is devoid of scientific basis [Cary, 2019].

2️⃣ Place a cushion between your legs (you can try this at different levels).

3️⃣ Put a cushion under your belly.

4️⃣ Use a positioning cushion (or pregnancy pillow; see on Amazon) like this:

• place the cushion between your legs, and bring it up in front of you to rest your head on it (see image 1 below);
• the same as above, bringing the cushion up behind you (see image 2 below).

5️⃣ For greater comfort and stability, use a cushion to support your upper arm (the one facing the ceiling).

3 tips for sleeping ON YOUR BELLY with sciatica

If you usually like to fall asleep on your stomach, here are 3 tricks to try to maintain your habit despite sciatica:

1️⃣ put one leg over the side, knee bent;

2️⃣ place a cushion on the lower abdomen, under the pelvis;

3️⃣ raise or lower your upper body with cushions or a reclining bed (see picture below).

Does this last tip surprise you? Perhaps you’ve read elsewhere that it’s important to try to preserve the “natural” curves of the back.

Perhaps you’ve even read that the stomach position is particularly harmful, as it bends the lower back backwards too much…

So, what are we to make of a piece of advice that encourages us to do the test of exaggerating this position?!

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