Trying to get a proper night’s rest and healthy sleep with sciatica can be difficult. Here we discuss how to combat sciatica discomfort for a better night’s rest. The sciatic nerves are the two largest nerves in the body. They run from the low back through the:

• Hips
• Buttocks
• Down each leg into the feet

When the nerve gets:

• Irritated
• Inflamed
• Pinched
• Compressed

Sciatica can cause pain, tingling, and numbness in the buttocks, lower back, leg, calf, and foot. It is a common condition that affects many individuals.

Is It Sciatica

Sciatica happens when the nerve becomes pinched from a bulging or herniated disc. In rare cases, the pain can result from a tumor putting pressure on the nerve or damage to the nerve caused by disease. The location and intensity of the pain depend on where the injury or damage occurred and how bad it is. Sciatica pain can be described as:

• Dull
• Sore
• Numbing
• Jolting
• Throbbing
• Hot
• Stabbing
• Radiating

For many, sciatica usually resolves within a matter of weeks. However, once sciatica has been presented, future episodes are almost guaranteed to resurface and, if not treated properly, can lead to more serious problems.

Symptoms

The sciatic nerve/s can affect several areas of the body, making symptoms vary. The most common include:

• Lower back pain starts at the low back and runs down each leg along the hips and buttocks.
• Pain radiates/spreads down the butt/leg area, sometimes described as shooting pain, and usually occurs on just one side.
• Pain while sitting for long periods places pressure on the gluteal muscles, lower back, and nerves. This can cause or worsen the condition. When having to sit for a while, it is recommended to get up every hour or so and walk/move around. This gets the blood flowing and stretches out the tightened muscles.
• The sciatic nerves run through the hip joint and, in some cases, can cause pain to settle in the hip. Injuries in the hip can mimic the symptoms of sciatica. If hip pain does not improve with time, get checked by a doctor to rule out other causes like osteoarthritis and bursitis.
• Numbness, some experience weakness in the legs and an altered sensation of numbness. This is caused by a herniated disc in the lower lumbar region.
• Burning/tingling like a pins and needles sensation, especially in the feet and toes.

Conditions/Causes

Several conditions can cause sciatica:

• Degenerative Disc Disease is where the spine’s discs deteriorate and become susceptible to painful herniation.
• Spondylolisthesis is a painful condition where the lower vertebrae slip forward onto the bone directly below, impinging the sciatic nerve.
• Muscle Spasms and involuntary contractions of the muscles can cause sciatica if they compress the nerve.
• Pregnancy sciatica is not uncommon. As the baby grows, it places pressure on the nerve causing aches and pains.
• Lumbar spinal stenosis is when the spaces in the low back begin to narrow, compressing and irritating the nerve.

Risk factors include:

• As the spine ages, it becomes more susceptible to herniated discs and bone spurs, which are the leading causes of sciatica.
• Obesity and excess weight create added stress on the spine, which can inflame the nerves.
• Occupation/work that requires standing/sitting for long periods or if a lot of heavy lifting is involved, there is added pressure on the back, increasing the risk for back problems.
• Individuals with diabetes have an increased risk for nerve damage. When nerves are damaged, they can cause radiating pain.

Night Time

Sleeping at night can be a challenge, especially not being able to get into a comfortable position. Sleep deficits and insufficient sleep can reduce the body’s tolerance to pain and worsen inflammation. Many wake up with increased symptoms.

This is likely due to the fact that when the body is lying down, the discs draw in and absorb fluid, which results in increased pressure within the disc, creating more pressure on the nerve. But some things to do to lessen pain and get a good night’s sleep. This includes changing sleep positions, stretching, and practicing healthy sleep hygiene.

Sleeping Positions

• Sleeping on the back is considered the best sleeping position for sciatica because it eases pressure on the low back and discs where the nerves are located.
• Sleeping on the side can be more comfortable and is a good position because it doesn’t place direct pressure on the muscles, discs, or sciatic nerve. But, it is important that the mattress is supportive enough to keep the spine aligned. If more support is needed, place a pillow between the legs.
• Sleeping with the knees elevated can help take the pressure off the low back. To achieve this, place a pillow under the knees or, with an adjustable bed, use it to elevate the foot of the bed.
• Sleeping with a body pillow provides extra comfort and helps the body remain in a certain position throughout the night. These pillows come in a variety of shapes and sizes.

Stretches

Stretching can provide relief. Stretching is important to keep the body flexible and prevent pain. Gentle stretches before bed and after waking up will loosen the muscles and ligaments surrounding the spine and joints.

• The reclining pigeon pose is yoga that opens the hips and eases lower back pain.
• Lying on the back with both knees bent.
• Lift the right leg and place the ankle on the top of the left knee. Hold the stretch for 15 to 30 seconds.
• Repeat with the other leg.

• The sitting pigeon pose stretch is similar to the reclining pigeon but is done while sitting.
• Sitting on the floor with knees bent. Keep balance by placing your hands on the floor.
• While seated, place the right ankle on the top of the left knee.
• Lean forward and move the upper body forward. Hold for 15 to 30 seconds.
• Repeat with the other leg.

• The forward pigeon pose is a more advanced version of the pigeon stretch.
• Start in a plank or push-up position.
• Move the right leg in front, so the right knee is toward the right wrist and the right foot toward the left wrist.
• Stretch the left leg out behind. The top of the foot should be on the ground, and the toes flat against the floor.
• Shift the weight forward onto the hands or elbows. Feel the stretch in the right glute.
• Repeat the steps with the other leg.

• Knee to opposite shoulder is a simple stretch that is easy and pain-relieving.
• Lie on your back with your legs extended.
• Bend the right leg, grasp the knee and pull it toward the abdomen.
• Straighten the leg and then repeat these steps with the left leg.
• Do three times on each side.

• Sitting spinal stretch can help open the vertebrae to relieve sciatica pain.
• Sit on the floor with your legs extended.
• Bend the right knee, so the foot is next to the inside of the left knee. Keep the right foot flat on the ground.
• Move the left arm around so that the elbow is on the outside of the right knee. Place right hand behind for balance.
• Gently turn toward the right, looking behind. Hold the position for 15 to 30 seconds.
• Repeat with the other leg.

• Standing hamstring stretch can ease pain in the hamstrings.
• Stand and place one heel on an elevated surface, like a chair.
• Fully extend the knee and flex the ankle by pointing the toes toward the ceiling.
• Bend forward at the hips, keeping the spine in a neutral position. Hold for 15 to 30 seconds.
• Repeat with the other leg.

Sleep Hygiene

Proper sleep hygiene helps prepare for a good night’s sleep. Here are some tips to help improve sleep hygiene.

• A nighttime routine will help unwind the body before bedtime. Start the routine 30 minutes before planning to go to sleep. Some things to do to help unwind:
• Take a warm bath
• Listen to relaxing/soothing music
• Meditation
• Reading

• Get a new mattress. An old, sagging mattress can worsen sciatica and strain the back. The best mattresses for sciatica pain combine contour comfort to ease pressure points at the hips and shoulders with the proper support to keep the spine aligned.

• Eye masks can help with artificial light, which can fool the mind and circadian clock into thinking it’s daylight. Keeping out unwanted light all night can help.

• Avoid blue light too close to bedtimes, like lamps and device screens. These are great for the day, as they help boost attention, reaction time, and mood. But at night, it can be disruptive. Turn off electronics 30 minutes before bed to help the body adjust.

• Room temperature control has found that most sleep better in a cool room. The optimal temperature is between 60 and 67 degrees.

• Avoid exercise close to bedtime. Working out before bed can interfere with sleep. This is because exercise releases adrenaline keeping the mind and body alert.

• Avoid stimulants, like caffeine, sugar, etc., to keep the body up before bedtime.

Medical Intervention

Sciatica pain can be mild or severe. Stretching or changing up the sleeping position can help ease discomfort. But if the pain is severe or chronic, and it prevents getting a good night’s sleep, consult a chiropractic professional.

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InBody Spotlight

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Sleep And Body Composition

A lack of sleep makes it harder to gain muscle and lose fat.

• Sleeping less means fewer opportunities to secrete growth hormones and develop muscle.
• Testosterone is negatively affected by lack of sleep
• Sleeping less can increase cortisol levels, impairing muscle development

• Irregular sleep throws off the body’s cycles, making the body feel hungrier
• Sleeping less is linked to eating more snacks, increasing energy levels
• Lack of sleep can cause reductions in Basal Metabolic Rate by 20%, reducing total energy output
• Being tired reduces spontaneous movements, reducing total energy output

Sufficient sleep is vital if trying to get into shape and change body composition. Any positive changes to get more sleep are going to have positive changes in efforts to change body composition.

References

Siengsukon, Catherine F et al. “Sleep Health Promotion: Practical Information for Physical Therapists.” Physical therapy vol. 97,8 (2017): 826-836. doi:10.1093/ptj/pzx057