Your sciatic nerve is the largest nerve in your body. It starts at your spinal cord, runs through your hips and buttocks, and continues down the back of each of your legs.

Sciatica is an impingement of your sciatica nerve. It’s most commonly caused by a herniated disc in your lower back. The hallmark symptom of sciatica is shooting pain along the nerve. Pain can vary from mild to excruciating and typically affects one side.

Getting a good night’s sleep with sciatica can be difficult. Lying in certain positions can put pressure on your irritated nerve and cause a flare-up of symptoms. However, some positions are less likely to cause pain.

Learn how to best sleep with sciatica.

Sciatica and other sources of low back pain can have a devastating effect on your sleep quality. Studies have found up to 55 percent of people with chronic lower back pain deal with sleep disturbances.

Finding the best position to relieve sciatica may be a matter of trial and error. But as a general rule, it’s a good idea to stick to positions that maintain the natural alignment of your spine.

On your side

You may find that sleeping on your side helps reduce pain by taking pressure off your irritated nerve.

How to set up:

  1. Lie on your mattress with your injured side on top.
  2. If there’s a gap between your waist and mattress, you may want to put a small pillow here to reduce side bending.

Place a pillow between your knees

Placing a pillow between your knees helps keep your pelvis and spine in a neutral position. It also prevents your legs from rotating during the night.

How to set up:

  1. First, put your shoulder on your mattress and then settle the rest of your body against your mattress.
  2. Bend knees slightly and put a thin pillow between them.
  3. You can also put a small pillow under your waist if there’s a gap.

Fetal position

The fetal position opens up space between your vertebrae and may reduce back pain caused by a herniated disc. However, some people also find it aggravates their pain.

If you experience discomfort in the fetal position, try one of the other positions on this list.

How to set up:

  1. Lie on your side and bring your knees to your chest so your body makes a “C.”
  2. You can also add a pillow between your knees or under your waist.

On your back with a pillow under your knees

Lying on your back helps distribute your weight evenly across your back. Putting a thick pillow under your knees may help maintain the curvature of your spine by relaxing your hip flexors.

How to set up:

  1. Lie on your back with a pillow under your head for support.
  2. Put one or two pillows under your knees and rest your heels comfortably against your mattress.

With a towel or pillow under your lower back

Putting a towel or thin pillow under your lower back can help keep your spine in a neutral position by reducing the gap between your back and mattress.

How to set up:

  1. Lie face-up with a comfortable pillow behind your head.
  2. Slide a thin pillow or towel under your lower back so that you can comfortably keep your pelvis in a neutral position.
  3. You can also combine this technique with a pillow under your knees if you find it more comfortable.

Sleep on the floor

Soft surfaces can cause your spine to bend out of proper alignment. You may find sleeping on the floor helps you better keep your spine in proper alignment.

How to set up:

  1. Put a thin mat such as a yoga mat or camping mat on the floor where you intend to sleep.
  2. Lie down in any of the positions above or any other position you find comfortable.

Doctors often recommend sleeping on your side during pregnancy.

Sleeping on your left side is often referred to as the ideal position because it’s thought to allow for optimal blood flow through your inferior vena cava. However, a 2019 review of studies found that sleeping on your left or right side is equally safe for you and your baby.

If you’re dealing with sciatica, you may find sleeping on your uninjured side helps reduce your symptoms. Putting a pillow between your waist and the mattress or putting a pillow between your knees may also help reduce pressure on your injured nerve.

It’s generally recommended that you avoid sleeping on your stomach if you’re dealing with sciatica or other forms of lower back pain.

When you sleep on your stomach, your spine tends to curve toward the mattress. This curvature can put stress on your muscles or joints, especially if you sleep on a soft mattress.

No matter what position you sleep in, it’s a good idea to avoid twisting your spine or hips since this may put pressure on your sciatic nerve.

Here are ways to help manage sciatic pain while sleeping.

  • Avoid soft mattresses. An overly soft mattress can cause your body to sink into it and put your spine out of alignment.
  • Try a medium to firm mattress. A 2015 review of studies found that mattresses self-identified as medium-firm were best for promoting sleep quality and spinal alignment. Try these mattresses best for sciatica.
  • Put plywood under your mattress. If you find your mattress too soft, try putting a plywood board between your mattress and boxspring. You can also try putting your mattress on the floor.
  • Consider a body pillow. A body pillow may help prevent you from flipping from your side to your stomach in the middle of the night.
  • Consider stretching or yoga. Adding light stretching or yoga to your pre-bed routine may help loosen your muscles and reduce pressure on your nerve.
  • Take a warm bath. Some people with lower back pain find a warm bath helps soothe their pain.
  • Follow good sleep hygiene. Following good sleep habits such as keeping your room at a comfortable temperature, going to bed at the same time each day, and avoiding caffeine before bed may help improve your overall sleep quality.

Some people with sciatica notice their symptoms get worse when they’re in bed. Lying down can increase pressure on your irritated nerve, especially if you sleep on a soft mattress that causes you to bend your spine while sleeping.

If you’ve been dealing with sciatica pain for more than a week, it’s important to visit a doctor for a proper diagnosis. They can help you determine what’s causing your sciatica pain and can recommend the best treatment options.

Many people with sciatica pain find lying down painful. In general, sleeping on your side or on your back tend to be better than sleeping on your stomach.

If you’re a side sleeper, you may find it helpful to put a pillow between your knees and/or between your waist and the mattress.

If you like to sleep on your back, you may find putting a pillow under your lower back and/or knees helps reduce pain.