Why Does My Sciatica Hurt Worse in the Morning?

Increased sciatica pain upon waking in the morning is a common complaint – you are not alone in this.

Here are the physiological and mechanical reasons for sciatic pain to flare in the morning – as well as tips on how to address the causes.

Morning Spine Stiffness

Overnight, your joints and soft tissues are inactive for hours. This inactivity leads to reduced lubrication in the facet joints and decreased flexibility in surrounding tissues.

If you have any degree of spinal arthritis or previous injuries, this morning stiffness can be even more pronounced.

The combination of a stiffer spine and an already-irritated sciatic nerve can make those first movements of the day particularly painful.

You can ease this painful stiffness by placing a warm heating pad under your back when you wake up, before you get out of bed. Leave it on for 10 to 15 minutes, then get up. The heat will bring blood flow to your lower spine, nourishing the muscles and soft tissues around the spine and reducing stiffness.

Watch How to Use Heat Therapy for Sciatica Pain Relief Video

Inflammatory Processes Peak at Night and Early Morning

Most causes of sciatica symptoms include some degree of inflammation.

During the night and in the early morning hours, pro-inflammatory cytokines such as TNF-α and IL-6 tend to peak.

This means your sciatica symptoms may feel worse during the night and in the morning when you wake up.

See How to Calm Sciatica Nerve Pain While You Sleep

Talk to your doctor about addressing inflammation, such as following an anti-inflammatory diet, taking anti-inflammatory supplements, and taking medication as recommended.

Sleeping Position and Mattress Support Matter

How you sleep can stress your sciatic nerve:

• Stomach sleeping: Often causes the lower back to arch and the spine to twist, especially if you bend one knee and move the leg up. This position tends to increase pressure on the lumbar discs and nerve roots.
• Back sleeping without knee support: Can flatten the natural lumbar curve, which increases disc pressure. This is especially true if you sleep on your back without placing a pillow under your knees, and if you sleep on an overly soft or saggy mattress.
• Side sleeping with poor pillow or mattress support: Some side-sleepers go into a fetal or curled up position, which tends to increase the symptoms of a herniated disc. Also, sleeping on your side tends to throw the spine out of alignment. See What to Look for in a Pillow if You Have Sciatica

All of these positions tend to increase stress on the sensitive lumbar nerve root, especially if your mattress is too soft or too firm, or if pillows don’t support your natural alignment.

Sleep in a position that supports your natural spinal alignment to reduce your sciatica symptoms in the morning.

See 3 Little-Known Tips for Sleeping with Sciatica

Generally, good sleep hygiene means to use a thin, firm pillow and if you like to sleep on your back then put a pillow under your knees. If you like to sleep on your side, place the pillow between your knees.

Muscle Tightness After Rest

When you’re inactive for hours, muscles like hamstrings, hip flexors, and piriformis tend to tighten.

The piriformis muscle can press against the sciatic nerve when tight, worsening symptoms.

Targeted morning stretching can help “wake up” these muscles, relieving some of the tension and pressure on the sciatic nerve.

Reduced Circulation During Sleep

Extended periods of stillness reduce blood flow to spinal structures and nerves.

This lower circulation can contribute to stiffness and make the nerve more irritable in the morning.

As you move around and circulation increases, pain tends to decrease. Another way to spur blood flow is to place a warm heating pad under your back for about 15 minutes when you wake up.

Nervous System Sensitization

If you’ve been dealing with sciatica for a while, your nervous system can become sensitized, a process known as central sensitization.

This means your nerves are more reactive to even small changes in pressure or position—common after a night of stillness—leading to more noticeable pain when waking up.

For more about managing sciatica and understanding its underlying causes, see our sciatica treatment articles and videos.

If morning pain persists or worsens, consult your healthcare provider for a tailored treatment plan.