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How to get a GOOD NIGHT'S sleep
It can quite easily become a vicious cycle. The Low Back Pain or Sciatica you are suffering with makes sleeping at best difficult and at worst impossible. This undoubtedly makes you very tired. When you are tired your perception of pain is increased and your pain threshold levels decreased. As a result of this, sleeping becomes even more difficult, which makes you more tired and so on...
So how can you address this? If your Low Back Pain or Sciatica is preventing you from getting a good night's sleep, the likelihood is it has nothing at all to do with the bed you are sleeping on, but rather the things you have been doing before you go to bed, or the position you are sleeping in while in bed. For the rest of this article, we are going to be discussing the latter i.e. the position you are sleeping in.
Typically, your pain will be aggravated by either extension based activities or flexion based activities. The type of activity that aggravates your pain is likely to dictate which position will give you the best night's sleep...
This refers to lying on your stomach. In this position, the laws of gravity and the give in the bed (even the firmest of mattresses will have an element of give in them) will encourage your back to arch down towards your stomach. This 'arching down' of the back is referred to as extension, and if your Low Back Pain/Sciatica does not like extension based activities, it is likely you are going to have a poor night's sleep if you continue with this position.
An alternative to try, before changing position completely, is to place a pillow or two under your stomach. This will prevent your back from 'arching down' as much and some people find they can gain a great deal of relief this way.
Prone Lying with Pillows
This is the complete opposite to Prone Lying and refers to the position where you lay on your back. When in this position, the laws of gravity and the give in the bed can encourage the back to arch in the opposite direction to prone lying i.e. a position of relative flexion. If your Low Back Pain/Sciatica does not like flexion based activities, then it is likely sleeping in this position will result in a poor nights sleep.
As is nearly always the case, things are not quite as straight forward as you'd expect. I am saying this because if there are tight muscles present at the front of the hip, and/or you have decreased stability about your low back and pelvis, then this can result in the opposite being true when lying in this position i.e. encourage the back to arch upwards into a position of relative extension. This will potentially aggravating Low Back Pain or Sciatica which does not like extension based activities.
If you feel this may be the case with yourself, I would suggest you try lying with your knees bent as shown below (often referred to as Crook Lying). Alternatively, you may prefer to try supine lying, but with a pillow or two placed under your knees.
I tend to find side lying, as a rule of thumb, the best position to sleep in. However, you will need to use a pillow or two for some support. This position in particular tends to be best for those that are still in the inflammatory stage of pain, where even the slightest of movements stir your pain up again.
In the diagram below, you can see how the typical position for someone to adopt when lying on their side, is where the top leg rolls forwards and down.
This position tends to put a twisting stress on the lower back as well as the soft tissues of the lower back, buttock and upper leg (which will include the Sciatic Nerve). If you were to sleep in this position, these increased stresses would potentially aggravate your pain, resulting in you waking during the night or waking in the morning with increased pain and stiffness.
On the other hand, if you were to place a pillow or two underneath your top leg for support...
Side Lying with Pillow(s) for support
This will help support the top leg and lower back in a more neutral position, which in turn will decrease the stress placed across the low back and associated structures, resulting in a better night's sleep.
Of all the positions I have covered above, it is the usually the last position, Side Lying with Pillow(s) for support, which people find the most beneficial. However, without sounding too flippant, the best position for you to sleep in is the position where you get the best night's sleep and wake up feeling most comfortable in the morning.
Based on what I have written above, try the positions which you feel will give you the best nights sleep, but ultimately listen to your body! If you are sleeping in a position which your Low Back Pain/Sciatica does not like, I am sure you do not need me to say that your pain will let you know. On the other hand, if it is a position which is better for you, your pain will be reduced and a better night's sleep will result.
It is important I finish this article by reinforcing that which I mentioned at the very top, it is not just the sleeping position which may be influencing your quality of sleep, but also what you have been doing the few hours before you go to bed as well.
If you are performing certain aggravating activities for your Low Back Pain or Sciatica the few hours before retiring to bed, this will undoubtedly unsettle your pain and consequently interfere with your sleep. The important thing therefore is to be able to identify those activities which may potentially aggravate your pain.
If you can identify any of these, and then modify them accordingly, you should find your sleeping, and also mornings, become a lot more tolerable. Combine this with identifying many other aggravating and easing factors for your pain, along with an appropriate exercise programme, and your pain should soon resolve.
In the mean time, I hope you enjoy a better night's sleep by taking on board the above advice.
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