The short answer: you can ease sciatica before you get up with a few gentle stretches done lying on your back in bed: pelvic tilts, knee rolls, knee to chest, a double knee hug and a lying piriformis stretch. Then sit on the edge of the bed for a nerve glide. NHS physiotherapists suggest short holds of 5 to 10 seconds and a few repeats. Stop any move that hurts. If you have numbness around your genitals or bottom, or bladder or bowel changes, get emergency help.
The alarm goes off and you already know. Before your feet touch the floor, there it is: a hot, tight line from your buttock down the back of your leg. You lie still, wondering how to get up without setting it off.
A few slow minutes on the mattress can take the edge off. Here’s how.
Why does sciatica hurt so much in bed?
Sciatica happens when something presses or rubs on the sciatic nerve, the NHS says. The most common cause is a slipped disc. Other causes include spinal stenosis, where the space for the nerves narrows, and back injuries. Not sure that’s what you have? Read what sciatica feels like.
NHS physiotherapists in Dorset say people with sciatica often find sitting, sleeping or driving positions painful. Holding these positions isn’t harmful, they add, but during bad spells it helps to try different positions and move more often. If your whole body feels creaky when you wake, our guide to being stiff in the morning covers the wider picture.
The same team points out that only 8 to 10% of back-related problems are thought to be truly nerve-related. Sore muscles and joints in the back and hip can cause leg pain too. If your pain sits around the hip, see hip pain radiating down the leg.
Before you start
- Your bed is fine. The Dorset NHS leaflet describes its lying exercises on a mat or your bed.
- Gentle means gentle. The American Academy of Orthopaedic Surgeons (AAOS) says you shouldn’t feel pain during an exercise. The NHS sciatica exercise video says to stop immediately if you feel any pain or become unwell.
- On a really bad morning, the Dorset physiotherapists suggest slow belly breathing in these positions instead, to help you relax and reduce pain.
7 sciatica stretches you can do in bed
Moves 1 to 6 are done lying on your back. Move 7 is done sitting on the edge of the bed, as the first step of getting up.
1. Pelvic tilt
- Lie on your back with your knees bent and your feet flat on the bed.
- Tighten your stomach muscles, gently flattening the small of your back into the mattress.
- Hold for 5 seconds, then relax. Repeat 5 times.
As it gets easier, NHS Ayrshire and Arran physiotherapists build up to a 20-second hold, 5 times, 3 to 4 times a day.
2. Knee rolls
- Lie on your back with your knees bent and together. Keep your back relaxed.
- Slowly let both knees roll to one side, only as far as is comfortable. Keep your shoulders on the bed.
- Hold for 10 seconds, then roll to the other side. Repeat 3 times on each side.
3. Single knee to chest
- Lie on your back with your knees bent.
- Bring one knee up and pull it gently toward your chest, holding behind your thigh or over your shin.
- Hold for 5 seconds, then lower. Repeat up to 5 times, then switch legs.
Later, NHS Ayrshire and Arran suggests a 10-second hold, 10 times with each leg, 3 to 4 times a day.
4. Double knee hug
- Lie on your back with your knees bent.
- Bring one knee up, then the other, and hold both gently toward your chest.
- Hold for 5 seconds, as the AAOS spine program suggests, then lower one leg at a time. Repeat a few times.
If it sends pain further down your leg, skip it.
5. Lying piriformis stretch
- Lie on your back with your legs straight.
- Lift your sore leg and bend the knee.
- With your opposite hand, gently pull that knee toward your opposite shoulder. You should feel the stretch in your buttock and hip.
- Hold for 15 to 30 seconds. Repeat 2 to 4 times, then try the other side.
These numbers come from Alberta Health Services’ piriformis exercise sheet.
6. Figure-four stretch
- Lie on your back with both knees bent and your feet flat.
- Rest the ankle of your sore leg on your other thigh, just above the knee.
- Use your hand to gently push the bent knee away from you.
- Hold for 15 to 30 seconds. Repeat 2 to 4 times, then switch sides.
Same Alberta sheet. Pick move 5 or 6 each morning, whichever feels better.
7. Nerve glide on the edge of the bed
- Roll onto your side and sit up on the edge of the bed (the steps are below).
- Slowly straighten the knee of your sore leg and point your toes while you look up toward the ceiling.
- Bend your knee to bring your foot back down while you lower your chin to your chest.
- Keep it slow and smooth for about 30 seconds.
This is the “sciatic nerve slider” from South Tees Hospitals NHS Foundation Trust, which says you shouldn’t feel pain at any point. NHS Ayrshire and Arran suggests nerve glides for 30 seconds, several times a day.
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A 5-minute morning routine
Do this before you get up. The times are rough estimates.
| Move | Hold and reps | About how long |
|---|---|---|
| 1. Pelvic tilt | 5 reps, 5-second hold | 40 seconds |
| 2. Knee rolls | 3 each side, 10-second hold | 70 seconds |
| 3. Single knee to chest | Up to 5 each leg, 5-second hold | 60 seconds |
| 4. Double knee hug | A few reps, 5-second hold | 20 seconds |
| 5 or 6. Piriformis or figure-four | 2 each side, 15 to 30 seconds | 80 seconds |
| 7. Nerve glide (sitting) | Slow and smooth | 30 seconds |
| Total | About 5 minutes |
Then get up and move. The NHS says to carry on with your normal activities as much as possible and to start gentle exercise as soon as you can. A short walk is a good next step. Here’s why walking is good for lower back pain.
How do you get out of bed with sciatica?
Use the log roll. It keeps your trunk straight so your back doesn’t twist as you rise. These steps are from Alberta Health Services:
- Lie on your side, facing the side of the bed you want to get out of.
- Use your arms to help raise your upper body as you lower your legs to the floor.
- Sit up straight on the side of the bed. This is a good moment for the nerve glide.
- Use your hands to help push yourself up to standing.
A short night routine for sciatica
Cleveland Clinic suggests one to two minutes of stretching, three to five times a day, including right before bed. It names the piriformis stretch as one to try. A simple wind-down:
- Warm up first. Cleveland Clinic says a warm soak before bed can ease sore muscles, and a heating pad or hot water bottle can help soreness. If your sciatica is new or newly flared, it says an ice pack may help instead.
- Two minutes of stretching. Try a pelvic tilt, knee rolls and move 5 or 6 from above.
Here’s how Cleveland Clinic suggests using pillows:
| Position | Pillow setup |
|---|---|
| On your side | Lie on the side opposite your pain, with a pillow between your knees. A pillow behind your back stops you rolling. |
| On your back | A small pillow under your head and neck, not your shoulders, and a pillow under your knees |
| Fetal position | On your side with your knees curled up |
| Spinal stenosis | A wedge pillow under your head and upper back, or a recliner or adjustable bed |
| On your stomach | Usually best avoided with sciatica |
There’s much more in how to sleep with lower back pain. If a sudden, hard knot in your calf wakes you, that’s more likely a cramp than sciatica. See leg cramps at night.
What to stop if the pain spreads
Physical therapists call it “centralization” when leg pain moves back up toward your spine during a movement. A review in the British Columbia Medical Journal describes this as a sign of a good outcome. When pain spreads further down the leg instead, outcomes were consistently poorer.
- Stop any stretch that sends pain further down your leg, or brings on new tingling or numbness in your foot.
- Check the next morning. NHS Ayrshire and Arran says pain should settle back to your usual level within 30 minutes of exercising. Pain or stiffness lasting more than 60 minutes the next morning means you did too much.
- Get advice if exercises cause a large increase in pain, the same NHS team says.
Long spells in a chair can stir it up too. Our guide to lower back pain from sitting has simple fixes for the day.
When to get help for sciatica
Call 911 or go to the emergency room if you have:
- Sciatica on both sides
- Weakness or numbness in both legs that’s severe or getting worse
- Numbness around or under your genitals, or around your bottom
- Trouble starting to pee, being unable to pee, or not being able to control when you pee, if that’s not normal for you
- Not noticing when you need to poo, or not being able to control it, if that’s not normal for you
- Back pain that started after a serious accident, such as a car accident or a bad fall
The NHS says these may be signs of a serious problem. Don’t drive yourself. Ask someone to take you, or call an ambulance.
See a doctor today if:
- You feel hot, cold, shivery or generally unwell with your back pain
- The pain is severe and started suddenly, or is getting worse quickly
- Your foot slaps down when you walk, or your walking or balance suddenly changes
The last point is from NHS Ayrshire and Arran, which says sudden changes like these need urgent assessment.
Book a regular appointment if the pain hasn’t improved after a few weeks of home treatment, is getting worse, or stops you doing your normal activities. Cleveland Clinic says many cases improve within four to six weeks. Here’s more on how long sciatica lasts.
Your next step
Tomorrow morning, before you sit up, try moves 1 to 3. Then log roll out of bed and take a short walk. When mornings feel easier, move on to our full sciatica exercises for the rest of the day, and these exercises for lower back pain. For the bigger picture, read how to get rid of back pain.
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Quick questions
Can you do sciatica stretches in bed?
Yes. NHS physiotherapists in Dorset describe knee rolls and pelvic tilts done lying on your bed, and knee to chest and lying piriformis stretches work the same way. Move slowly, keep each stretch gentle, and stop any move that brings on pain.
How long should you hold a sciatica stretch?
Most gentle sciatica stretches are held for 5 to 30 seconds. NHS physiotherapists suggest 5 seconds for a pelvic tilt or knee to chest and 10 seconds for knee rolls. Alberta Health Services suggests 15 to 30 seconds for piriformis stretches, repeated 2 to 4 times.
Should I stay in bed with sciatica?
No. The NHS says not to sit or lie down for long periods, because moving isn’t harmful and can help you get better faster. Arthritis UK says bed rest does more harm than good. Stretch gently, then get up and keep up your normal activities as much as you can.
What is the best sleeping position for sciatica?
Cleveland Clinic suggests sleeping on the side opposite your pain with a pillow between your knees, or on your back with a pillow under your knees. Curling up in the fetal position can also help. It says stomach sleeping is usually best avoided.
Is it good to stretch before bed with sciatica?
Yes, if the stretches feel gentle. Cleveland Clinic suggests one to two minutes of stretching, three to five times a day, including right before bed. A piriformis stretch is one it names. A warm bath or a heating pad before bed may also ease soreness.
How do you get out of bed with sciatica?
Use the log roll. Lie on your side facing the edge of the bed, then use your arms to raise your upper body as you lower your legs to the floor. Sit up straight, then push up with your hands to stand. This keeps your back from twisting.
When is sciatica an emergency?
Call 911 or go to the emergency room if you have sciatica in both legs, severe or worsening weakness or numbness in both legs, numbness around your genitals or bottom, or new trouble controlling your bladder or bowels. The NHS also says to get emergency help for back pain after a serious accident.
This article is general information, not medical advice. Stop any stretch that causes pain or sends pain further down your leg. If you have any of the emergency signs above, get help straight away. Ask your doctor or physical therapist which stretches are right for you.
Sources
- NHS. Sciatica.
- NHS. Back pain.
- NHS. Exercises for sciatica.
- Dorset Musculoskeletal Service (NHS). Back pain: leg pain and sciatica.
- NHS Ayrshire and Arran. Lumbar spinal stenosis (MSK patient portal).
- South Tees Hospitals NHS Foundation Trust. Sciatic nerve slider.
- Cambridge University Hospitals (NHS). Back mobility exercises.
- American Academy of Orthopaedic Surgeons, OrthoInfo. Spine conditioning program.
- Alberta Health Services, MyHealth Alberta. Piriformis syndrome: exercises.
- Alberta Health Services, MyHealth Alberta. Log roll method for safe movement.
- Cleveland Clinic. Sciatica.
- Cleveland Clinic. How To Get Better Sleep With Sciatica Pain.
- Chartered Society of Physiotherapy. Treatment for back pain.
- Arthritis UK. Back pain: symptoms, causes and treatment.
- Davies CL, Blackwood CM. The centralization phenomenon: its role in the assessment and management of low back pain. British Columbia Medical Journal, 2004.