One common complaint of sciatica—sharp, shooting nerve pain in the leg—is that pain can feel worse in some positions, such as when lying down to go to sleep. Sometimes sciatica may prevent you from falling asleep, or it could be so severe that you wake up in the middle of the night with throbbing pain.

Sciatic nerve pain occurs when an underlying condition causes a nerve root in the lower spine or pelvis to become pinched, irritated, or inflamed. Watch: Sciatica Overview Video

Sciatic nerve pain occurs when a nerve root in the lower spine or pelvis is pinched, irritated, or inflamed. A variety of conditions can cause this type of leg pain, from a herniated disc to a bone spur to a tense piriformis muscle. Continue reading below for information on how leg pain typically occurs while lying down and how to find relief.

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Leg pain while lying on the back

When lying on your back, the lower spine’s natural inward curve (called the lumbar lordosis) is more accentuated than when sitting or reclining. Holding the spine in this position decreases the size of the passageways (foramina) where nerve roots exit the spinal column. If a herniated disc or bone spur is present, this position can directly pinch a nerve root and result in sciatic leg pain (called lumbar spinal stenosis).

See Lumbar Spinal Stenosis

You can typically ease sciatica pain while lying on your back by keeping your legs slightly elevated. This position will remove pressure from your lower spine and open up the nerve passageways.

Watch: 3 Tips for Sleeping with Sciatica Video

For example, try sleeping with a pillow beneath your knees. If you have an adjustable mattress or reclining chair, sleeping with your knees propped up can reduce the inward curve of the spine and help you get a good night’s sleep.

See Mattresses and Sleep Positions for Each Back Pain Diagnosis

Leg pain while lying on the side

Lying on the side can cause or exacerbate leg pain in a couple ways:

  • Putting direct pressure on a nerve root by lying on the leg affected by sciatic pain.
  • Lying with the hips tilted too far to one side, which causes the spine to curve, pinching the nerve roots and causing leg pain. For example, lying on the unaffected leg can cause the affected hip to curve too far up toward the ceiling, pinching a nerve root and causing pain in the affected leg.

If you tend to sleep on your side, it is usually recommended to lie on the unaffected leg. However, this advice doesn’t work for everyone, and you may find that the reverse is more comfortable.

To prevent leg pain when sleeping on your side, try placing a pillow between your legs and keeping your hips in alignment with your spine, rather than curved to the side.

Watch: Pillow Tips for Sciatica Video

When to see a doctor for leg pain while lying down

If leg pain makes it difficult to fall asleep or keeps waking you up at night, schedule an appointment with your doctor. In addition to sciatica, other potential causes of leg pain when lying down include peripheral arterial disease (PAD) and muscle cramps. Getting an accurate diagnosis can help you get the right treatment and find relief sooner.

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When you go to the doctor, try to describe how your leg pain feels, such as sharp and hot, dull and throbbing, or like it’s shooting down your leg. Additionally, let your doctor know which positions relieve or exacerbate your pain. This information can help your doctor more precisely identify remedies and treatments that can reduce pain, such as ergonomic pillows or cushions.

See Types of Sciatic Nerve Pain

Learn more:

What Is Piriformis Syndrome?

Sciatica Treatment Video