Leg pain when lying down - is it sciatica?

Last reviewed by Pedro Santos, a registered nurse in our Health and Hand team in April 2020.

The symptoms you mention could indeed be sciatica, although there are other conditions with similar symptoms.

Sciatica is the name given to pain that radiates from the sciatic nerve, the longest nerve in the body. It runs from your lower back, through your buttocks, and all the way down both legs to your feet. Pain is usually caused by compression of the nerve or when one of the vertebral discs “bursts” and leaks its contents on to the nerve.

Sciatica usually resolves itself without any medical intervention but in some cases requires more complex pain management.

How to recognise sciatica

• It affects one leg (not both).
  
  
• Sharp pain (rather than a throbbing or dull ache) that extends from the lower back into the buttock, thigh and potentially along the full length of the sciatic nerve to the foot.
  
  
• Can cause weakness in the leg or foot.
  
  
• Pressure, numbness, tingling and/or a burning sensation are other common symptoms.

Self help tips to relieve sciatica and severe back pain

As general advice for any sciatica type of pain, the following recommendations seem to provide some relief:

• Using hot/cold packs on your lower back.
  
  
• Keeping active and following a physiotherapy program to strengthen the area.
  
  
• Taking over the counter painkillers (paracetamol, ibuprofen, etc.).

Our article, Top 10 exercises for a healthy back, is also well worth a visit for tips and videos of exercises you can try to help manage lower back pain, as recommended by our musculoskeletal team.

Considering your main complaint is pain when lying down it’s worthwhile revisiting some of the basics for a good night’s sleep:

• A good firm mattress that supports your spine.
  
  
• A pillow that keeps the alignment of your spine when lying down.
  
  
• If you sleep on your side, you  may find it beneficial to use pillows in between the legs to maintain the alignment of the hip joint. Usually one pillow is enough to do the trick.
  
  
• If you sleep on your back, try putting a small pillow under the knees to create a small elevation, which helps relieve pressure from lower back.

There are plenty more tips and techniques to help you to fall asleep and get a better quality of sleep in our sleep centre.

Next steps

Our advice is that you follow these recommendations for a week or two and if there’s no improvement, contact your GP. They should be able to formally diagnose your condition, arrange for further investigations if appropriate, and help you to manage the pain going forward.

Answered by the Health at Hand team.

Sources and further reading

Sciatica – NHS factsheet
Top 10 exercises for a healthy back – AXA Health

Useful resources

Sleep centre – AXA Health