Sleeping with lower back pain and sciatica can be difficult and frustrating. What are ways to get more comfortable sleep?
Sleeping With Lower Back Pain and Sciatica
Various factors can affect sleeping with lower back pain and sciatica, including age, injury and medical history, the mattress (e.g., soft vs. firm mattress), and sleep positions. Unfortunately, there’s no one-cure-all solution for this problem, and depending on the underlying cause/s, they can worsen the pain and cause sleep problems. For example, if a herniated disc places added pressure on the nerves in the lower back, twisting the spine can worsen the lower back pain, and sleeping in a fetal position can exacerbate the nerve pain. (UCF Health, N.D.)
Lower-Back Pain
Low-back pain can be activity-related, intermittent, or constant. (American Association of Neurological Surgeons, 2024) For some, it only occurs occasionally, such as when performing specific movements. For others, it can be excruciating, chronic, and disabling. Low-back pain is unique for everybody and can differ depending on the cause. Some low-back pain symptom descriptions include (Förster M. et al., 2013)
Aching pain deep in the back
Shooting pain flare-ups
Pain caused by slight pressure
Burning
Tingling
Sciatica Not Present
For some, low-back pain may be confined to a specific area known as axial back pain. (Förster M. et al., 2013) The pain may be felt in a band along the lower back and does not radiate down the legs or anywhere else.
Sensory changes radiating down the leg – numbness, burning, and or tingling
Sleep Tools
Consider changing the mattress to improve sleeping with lower back pain and sciatica. For the best spinal support, choose a medium to firm mattress. Pillows, wedges, and other tools can also help improve sleep. (UCF Health, N.D.) It is recommended that individuals who sleep on their backs place a small pillow under their knees to reduce pressure on their lower backs. For those who sleep on their side, placing a pillow between the knees can keep the spine in a neutral/straight position. To relieve lower back pain, consider sleeping in a reclined, angled position with the head and shoulders higher than the hips. This can be accomplished with an adjustable bed or a wedge to prop the body in a regular bed.
Back Sleeping
Easing back pain while sleeping involves maintaining the body in a neutral or straight position. Extending the muscles, tendons, and ligaments too far in any one direction while sleeping with lower back pain and sciatica can cause stiffness, muscle spasms, and pain. Sleeping on the back puts the spine in neutral alignment with the least stress on the neck and back. It evenly distributes body weight to avoid exerting pressure on the joints and prevent backaches. In addition, a supine position allows outstretched ligaments to shrink and recover to their normal positions. (Keck Medicine of USC, 2019)
Chiropractic Assessment
Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic physical therapy team may be best for individuals with acute back, neck, and musculoskeletal pain and discomfort symptoms. A chiropractor can quickly assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Sciatica, Causes, Symptoms and Tips
References
UCF Health. (N.D.). The best sleeping position for lower back pain (and the worst). https://ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/
American Association of Neurological Surgeons. (2024). Low back pain. https://www.aans.org/patients/conditions-treatments/low-back-pain/
Förster, M., Mahn, F., Gockel, U., Brosz, M., Freynhagen, R., Tölle, T. R., & Baron, R. (2013). Axial low back pain: one painful area–many perceptions and mechanisms. PloS one, 8(7), e68273. https://doi.org/10.1371/journal.pone.0068273
North American Spine Society. (2020). Evidence-based clinical guidelines for multidisciplinary spine care: Diagnosis and treatment of low back pain. North American Spine Society. https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf
American Academy of Orthopaedic Surgeons. (2021). Sciatica. https://orthoinfo.aaos.org/en/diseases–conditions/sciatica
Keck Medicine of USC. (2019). The best -and worst – sleep positions for back pain. Keck Medicine of USC Blog. https://www.keckmedicine.org/blog/the-best-and-worst-sleep-positions-for-back-pain/
Individuals with plantar fasciitis may experience consistent flare-ups. Can knowing the causes help to find pain relief?
Plantar Fasciitis Flare-Up
Plantar fasciitis is a common cause of heel and foot pain. The plantar fascia is a band of tissue that runs along the bottom of the foot and becomes inflamed. Certain factors can cause plantar fasciitis flare-ups, including:
Increased levels of physical activity.
Not stretching regularly.
Wearing shoes without proper support.
Weight gain.
Causes
A plantar fasciitis flare-up is often triggered by physical activity. (MedlinePlus. U.S. National Library of Medicine. 2022) It can also be brought on by underlying conditions, like increased body weight, arthritis, or the shape of the foot. (Johns Hopkins Medicine. 2023) Despite the root cause, there are activities and experiences that can contribute to and/or worsen the condition.
New Exercise Routine
Being highly physically active can exacerbate plantar fasciitis symptoms.
High heels, boots, or shoes that raise the heel above the toes.
Worn-out shoes like exercise workout shoes.
Not Stretching Properly or At All
Tight calves can increase pressure on the plantar fascia.
Stretching the calves, Achilles tendon/heel, and the bottom of the feet is highly recommended to help treat and prevent the condition. (Johns Hopkins Medicine. 2023)
Not stretching thoroughly or skipping stretches can worsen symptoms.
Individuals with plantar fasciitis are recommended to stretch before and after physical activities, exercise, before going to bed, and after waking up.
Working Through the Pain
Individuals may try to continue physical activities during a flare-up.
This is not recommended as doing so can cause more pain and worsen the condition.
When pain presents, it’s recommended to:
Stop all activities that strain the feet
Stay off the feet for at least a week.
Tearing the Plantar Fascia
The plantar fascia rarely tear completely from repeated stress known as a plantar fascia rupture.
Pascoe, S. C., & Mazzola, T. J. (2016). Acute Medial Plantar Fascia Tear. The Journal of orthopaedic and sports physical therapy, 46(6), 495. https://doi.org/10.2519/jospt.2016.0409
Managing rheumatoid arthritis is an ongoing balancing act. Flare-ups can still present despite following the rheumatologist’s lifestyle instructions, proper medication use, and a well-maintained RA plan. Monitoring daily activities can help minimize the chances of experiencing episodes.
Rheumatoid Arthritis Flare-Ups
A rheumatoid arthritis flare-up is a short-term escalation of arthritis symptoms. A flare-up can go away within a day or can persist for several weeks or months. A flare-up usually involves joint stiffness and pain but can also present as any symptoms worsening. If the flare-up is severe, it can affect the ability to perform regular everyday activities.
Symptoms
Symptoms can vary, and not every person experiences the same. Most individuals describe flare-ups with a sudden increase in:
Pain
Stiffness
Swelling
Limited joint mobility
Fatigue
Symptoms that feel like the flu.
Frequency and severity can also vary.
Back Pain Symptoms
Rheumatoid arthritis can affect many joints. It is the inflammation of a joint’s synovial membrane. These include the facet joints in the spine. The most commonplace in the spine affected by rheumatoid arthritis is the upper neck, around the base of the skull. The joints at the top of the neck get inflamed and can become unstable or form abnormal tissue that sticks out and compress the spinal cord.
Triggers
Several potential flare-up triggers include:
Stress
Not getting enough sleep
Medication changes
Injury
Excessive physical activity and/or exercise
Repetitive overuse injury
Smoking
Spinal infections
Airborne toxins can also be a trigger to a flare-up. Substances include chemicals like household cleaners. Switching to organic and environmentally safe cleaners can help. Airborne toxins are a concern in densely populated cities and areas that experience air pollution and smog. To minimize risks, staying indoors during times of poor air quality is recommended.
However, flare-ups can happen without an identifiable trigger. Certain foods can increase inflammation and could contribute to a flare-up, including:
Avoiding these foods and following a diet that has been developed to prevent symptoms will help significantly. The objective is to learn to identify an RA flare-up to moderate activities accordingly.
Prevention
Managing any chronic medical condition is challenging, especially when trying to predict when a flare-up will happen. There is not a foolproof strategy for prevention, but advice that can help minimize the risks of an RA flare-up.
Understand that the disease can change over time. This means changes in medications and the need for multi-approach treatment. Learning healthy self-care techniques will go a long way in managing symptoms.
Body Composition
Antioxidants protection
Metabolic processes, like energy production, and environmental pollution, can result in free radical production. These are highly reactive molecules that can damage the body’s cells and lead to oxidative stress. This can develop into a disease, including heart disease. The body has natural protective mechanisms to neutralize free radical molecules, including glutathione, which is the body’s top antioxidant. If glutathione becomes depleted because of increased free radicals, the body switches to dietary antioxidants from food as a secondary defense.
Pham-Huy, Lien Ai et al. “Free radicals, antioxidants in disease and health.” International Journal of biomedical science: IJBS vol. 4,2 (2008): 89-96.
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