How To Sleep With Piriformis Syndrome And Sciatica (Best Sleeping Positions!)

Piriformis syndrome is such an exhausting chronic condition sleep can feel like the only escape from the daily pain.

Yet, sleeping with a tight piriformis muscle is also not that easy.

Only a person who’s experienced piriformis syndrome (like me) can comprehend how hard it is to live with this chronic condition.

In this post, I’ll share the best ways to sleep with piriformis syndrome.

Plus, I’ll include sleeping tips to help you relax your body so you can finally get a good night’s sleep and forget about the piriformis pain at last.

Your posture during sleep determines the quality of your sleep and how you feel the next day.

Below are the best sleeping positions for both piriformis and sciatica pain relief.


Feeling overwhelmed about how to fix piriformis syndrome? Here’s a simple home recovery program that’ll teach you all the techniques I used to fix this frustrating chronic condition and remain pain-free for over 4 years.

How To Sleep With Piriformis Syndrome – Best Positions

Scroll below the video to read the step-by-step guide (with images).

How To Sleep With Piriformis Syndrome And Sciatica (Best Sleeping Positions)

Back Sleeping

Sleeping on your back is the best way to maintain spinal alignment and help your hip muscles relax.

From experience, sleeping on the back (while recommended) can feel uncomfortable if you have piriformis syndrome or experience sciatica.

Sometimes the pain can radiate down to your knee making it hard for your leg to move.

Here’s how to fix this:

sleeping lower back pain
how to sleep with sciatica
  • To avoid irritating the hip muscles, including the piriformis, or getting those radiating spasms, place a supportive pillow or a folded blanket below your lumbar spine to ensure your spine is parallel to the floor.
  • To further support the hips and back, place a pillow or rolled blanket below the knees. Keeping the knees straightened and not flexed higher up to avoid hip flexor tightness. 
  • Make sure the pillow is not very high. All you want is a bit of elevation to support the knees. 
piriformis syndrome sleeping tips

Side sleeping

Sleeping on your side can feel comfortable initially. However, you slowly start to feel your piriformis tightening up again.

Here’s how to sleep on your side without irritating the piriformis muscle:

piriformis syndrome side sleeping
  • Place a pillow or pad between the knees that covers the area from the knee to the ankle to reduce the tension on the hip muscles.

If you usually use a pillow but place it between your thighs further up, your upper foot will come down.

  • By placing the pillow further down, we avoid the upper ankle collapsing down pushing the hip to rotate forward.
  • You can also use an additional pillow to hug. Hugging a pillow will support your shoulders and stop them from rounding forward.

Rounded shoulders can also contribute to lower back pain.

sleeping positions best sleeping
Side sleeping correct posture

If you can, also place a folded blanket underneath your lumbar area as well. This is optional and should be considered if you feel your mattress is too firm for your back.

Stomack Sleeping

Avoid stomach sleeping as much as possible. When you sleep on your stomach, you’re more likely to rotate your neck to one side, putting a lot of pressure on the cervical spine.

Staying in this position for hours at night can affect your posture and how you feel the next morning.

Which Pillow To Use For A Better Sleep

It’s up to you which pillow brand or style you use. Just keep the following in mind when choosing your new pillow:

Your pillow should keep your neck aligned.

A pillow that’s too high will push your neck forward putting more pressure and tension on the cervical spine.

sleeping posture sciatica and neck pain
Incorrect sleep posture

Putting your cervical spine under stress will have an effect on your thoracic and lumbar spine.

piriformis syndrome sleeping posture

Now using a pillow will also leave the cervical spine without adequate support.

It’s important to have the right support for your neck, shoulders, and upper back.

It’s up to you which pillow you prefer to use, but just make sure there is adequate support and that your head is aligned with your back.

As long as the area underneath your neck has support, your head can rest back down.

spinal alignment sleep
Correct neck and spine alignment

Recommended pillow: I personally switched to this amazing natural goose down pillow and I permanently stopped experiencing neck pain. It’s been such an amazing change. I wanted to include the pillow here because it may also help you if you always wake up with neck pain.

Mattress Tips

Unlike getting a new pillow, usually getting a new mattress demands a bit of planning and budgeting.

I understand if you’re not able to get a firmer or more supportive mattress. There are many pads that can help you improve your sleep.

I personally start to get hip pain sleeping on very soft mattresses.

I find that medium-firm pads or mattresses work best. 

Following the tips above will help you maintain alignment while you sleep on your current mattress.

Piriformis Syndrome & Sciatica Sleeping Tips

Here are a few of my favorite before-bed habits to help you reduce piriformis overactivity and tightness.

Daily Good Posture

If you’re mindful about keeping a good posture throughout the day, you’ll be less likely to develop tension. Here’s a good tutorial on how to sit with piriformis syndrome to reduce spinal damage.

Warm Showers Or Baths

Warm showers are very relaxing and will help your body relax and slow down. Warm showers also increase blood circulation which can help reduce inflammation.

Magnesium Supplement

Magnesium is a natural muscle relaxant that will help your muscles relax. I also notice that I sleep all through the night when I take magnesium.

Disclaimer: Always consult with your doctor first before starting a new supplement. Especially if you’ve never taken magnesium or you’re taking other medication.

Gentle Piriformis Release

Internal hip rotations
Gentle piriformis stretches

Gentle piriformis stretches before bed can be beneficial as stretching slows the body down.

Self-myofascial release of the hip flexors, quads, and hamstrings can help release the tension that built up throughout the day.

Core Strengthening Exercises

If you experience sciatica (nerve pain radiating down the leg), include core strengthening exercises during the day to stabilize and support the spine during the day.

If you have weak core muscles, you’ll be putting more pressure on your lumbar spine throughout the day, and start to feel the symptoms of spinal compression later in the evening.

Working on strengthening your deep core muscles including the transverse abdominis will pay off later in the day.

Feeling overwhelmed about how to fix piriformis syndrome? Here’s a simple home recovery program that’ll teach you all the techniques I used to fix this frustrating chronic condition and remain pain-free for over 4 years.

I hope these piriformis and sciatica sleeping tips have been helpful.

Check out my other top posts below for more info on how to fix piriformis syndrome.

Coach Sofia
  • just talking to someone about pain and exercise who knows what they are talking about is so reassuring thank you so so much

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