The 5 Best Sleeping Positions for Sciatica (and How to Set Up Your Pillows)

By Mark from Outback, The Outback Series customer care7 min read

Why sleep gets so hard

Sleeping with sciatica can feel like trying to get comfortable on a bed of rocks. I have spent plenty of nights flipping around like a fish, looking for a position that does not make things worse. If that sounds familiar, the five positions below are the ones that come up again and again, from physical therapists and from our own customers.

The idea behind all of them is the same: keep your spine in a neutral line and take the twist and pressure off your lower back and hips. Pillows do most of that work.

The 5 positions at a glance

1. Side sleeping with a pillow between your knees

I used to think sleeping on my side was enough. It turns out I was missing the most important part: the pillow between the knees.

When you sleep on your side without support, your top leg drops forward and down, which pulls your pelvis and twists your lower back. A pillow between your knees keeps your hips stacked and your spine in line.

• If one leg feels worse than the other, sleep on the opposite side, with the sore side up.
• Use a thick, firm pillow that does not go flat by morning. A knee pillow or a body pillow works well.
• Keep your head pillow at a height that lines your nose up with the middle of your chest.

2. The fetal position (keep it loose)

If straight side lying is not cutting it, try curling into a loose fetal position: on your side, knees drawn up partway toward your chest, pillow still between them. Many people whose leg feels easier when they lean forward find this position more comfortable.

• Do: keep your back gently rounded and comfortable, with a pillow that keeps your head level with your spine.
• Do not: pull your knees tight to your chest or curl your head and shoulders far forward. You will just wake up stiff.

3. On your back with your legs raised

Lying flat on your back with straight legs can arch your lower back. Raising your knees lets it relax into the mattress.

• Lie on your back and place two or three pillows, or a wedge, under your knees.
• Let your hips and lower back settle. Do not force them flat.
• If your legs feel strained, add a pillow under your calves too.
• A small rolled towel under your waist can help if there is a gap between your lower back and the mattress.

4. Stomach sleeping (if you must)

I was a stomach sleeper for years. For most people it is the hardest position on the lower back, because it lets your lower back sag and keeps your head turned to one side all night.

If it is the only way you can sleep, make it easier on yourself:

• Put a thin pillow under your hips so your lower back does not sag.
• Use a flat pillow, or none, under your head to spare your neck.
• Try sleeping with one knee bent out to the side.

5. The recliner position

Ever dozed off in a recliner and woken up feeling better? A slight recline takes pressure off the lower back for many people, especially those who feel easier sitting or bending forward than standing or lying flat.

No recliner? Mimic it with an adjustable bed or a wedge pillow under your upper body, with pillows under your knees so they stay bent.

Is sleeping on the floor better for sciatica?

Some people swear by it, mostly because the floor does not sag the way an old mattress does. But a hard floor also puts pressure on your hips and shoulders, and getting down to and up from the floor is a real risk if your back or legs are sore.

If your mattress sags, a firmer mattress topper or a sheet of plywood under the mattress gets you the same support without the climb. Most guidance points to a medium-firm mattress as the best balance of support and comfort.

A 10-minute wind-down before bed

1. Warm up your lower back (10 minutes while you read or watch TV). A heat pack or hot water bottle on the area can ease stiffness. Wrap it in a towel and never sleep on it.
2. Stretch gently (1 to 2 minutes). Physical therapists often suggest easy stretches such as lying on your back and drawing one knee toward your chest. Stop if it sends pain down your leg.
3. Massage your lower back and hips (1 minute). With enough oil to cover the area, slow circles on each side of your spine and across your hips help you settle before you lie down.
4. Set up your pillows first, then get into bed, so you are not wrestling them in the dark.

When to call your doctor

See your doctor if your symptoms have not improved after a few weeks of home care, are getting worse, or stop you doing your normal activities.

Get emergency help right away if you have symptoms in both legs, weakness or numbness in both legs that is severe or getting worse, numbness around your genitals or bottom, or you suddenly cannot control your bladder or bowels.

What we keep on the nightstand

Outback Pain Relief Cream

Natural menthol (16%) and camphor (6%) on top of four Australian oils, for temporary relief of minor aches and pains of muscles and joints associated with simple backache, arthritis, strains, bruises and sprains. Do not use it with a heating pad, so pick one or the other at bedtime. Covered by our 365-Day Returnless Refund.

See the cream

Prefer no tingle? Outback Original Oil is four Australian plant ingredients with nothing that burns or freezes, nice for a slow lower-back and hip massage before bed. And if magnesium is part of your evening, Outback Magnesium+ is made to support relaxation and restful sleep.*

Frequently asked questions

More reading

• When to take magnesium for sleep
• How to apply lotion to your own back
• Outback for your back
• How to use Outback Original Oil

Sources: Cleveland Clinic: How To Get Better Sleep With Sciatica Pain; NHS: Sciatica.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is general information, not medical advice. If you have sciatica or ongoing back or leg pain, talk with your doctor about what is right for you. Use any product as its label directs.