Piriformis syndrome pain can affect the quality of your sleep, but there are steps you can take to improve both. Understanding how your sleep affects spinal support and how it contributes to back pain will allow you to make the necessary changes to your mattress type, sleeping position, and pillow usage and get a good night’s sleep. Additional measures, such as regular stretching, can also be beneficial for people who have difficulty getting a good night’s sleep with this condition.

What is Piriformis Syndrome?

Piriformis syndrome is a condition in which the sciatic nerve is irritated by the piriformis muscle (located behind the hip joint in the buttocks). Piriformis syndrome can cause pain, tingling, and numbness along the back of the leg all the way down to the foot. This is not the same as sciatica.

In people with sciatica, the pain signals travel along the nerve, while in people with piriformis syndrome the pain is muscular in origin.

In many cases, the cause is not identified. Some of the recognized causes of piriformis syndrome include:

  • Irritation of the piriformis muscle itself or irritation of a nearby structure such as the sacroiliac joint or hip
  • injury
  • Abnormal development or location of the piriformis muscle or sciatic nerve
  • Abnormal alignment of the spine (such as scoliosis)
  • Leg length difference
  • Previous hip surgery
  • Foot problems, including Morton’s neuroma


The right mattress

Getting enough sleep is essential to managing the pain associated with piriformis syndrome – and it all starts with your bed.

There isn’t one mattress that is right for everyone with piriformis syndrome, but sleeping on the wrong mattress can cause or worsen lower back pain by aggravating poor sleeping posture, straining muscles, and out of alignment with the spine.Choosing the right mattress for you can help reduce spinal pain and improve your spinal alignment and quality of sleep.

Studies have shown that the ideal mattress for promoting sleeping comfort, quality and spinal alignment is medium-firm and individually inflated (self-adjusted).You should also consider the two factors that affect the quality of the mattress: support and cushioning / comfort.

When supporting, think about the internal structure of the mattress. The perfect level of support will depend on a few factors including your preferences, height and weight, and sleeping style.


Back-saving sleeping positions

Your sleeping position can also help with your back pain. The best and worst sleeping positions for neck or back pain are:

    • Sleep on the back: When you’re not pregnant, lying on your back is the ideal position for spine alignment and support. However, many people find it difficult to sleep in this position.The right pillows in the right position can help
    • Side sleep: This is the second best option for preventing sleep-related back pain and joint pain, and is also an excellent choice for people with sleep apnea or snoring as it helps keep the airway open.Pregnant women will find that this position is the best support for their back. Remember to keep your legs straight or only slightly bent. Fully bent knees can cause uneven weight distribution. It is also recommended that you tuck your chin back to support your spine
    • Lying position: If you experience pain that feels more severe when standing up and better when leaning forward, it is recommended that you sleep in a reclined position.That means sleeping in a recliner or an adjustable bed. You can also find comfort and support through the use of a wedge pillow


Why you should never sleep on your stomach

Sleeping on your stomach is the worst choice for your spinal health as it puts pressure on your joints and muscles and requires you to turn your head to one side. This puts extra pressure on the neck and spine. If you’re struggling to change your sleeping position, the Sleep Foundation recommends using just a thin pillow under your head and placing a more supportive pillow under your hips and stomach to relieve pressure.


Pillow types, shapes and positions

The choice of pillow also plays a major role in back pain. The right pillow can help keep your upper spine in alignment and relieve pressure on your body.

An orthopedic pillow is better for people with back pain than other options like memory foam and goose down or filled with feathers.However, orthopedic pillows come in many varieties, and the best type will vary based on your sleeping style, height, and weight. Different contour designs also change the comfort and level of support.

Here are the best types of pillows for any sleeping position:

  • Back sleeper: Choose a medium-thin pillow and place it under your head. Add a neck pillow and one or two pillows under the knees for ultimate support and even weight distribution
  • Side sleeper: Choose a medium-thick pillow under your head and add a pillow between your knees to encourage a neutral spine alignment. Side sleepers will also find comfort and support from body pillows
  • Lying sleepers: Choose pillows like wedge pillows to help keep your head and knees high and reduce pressure on your lower back
  • Belly sleeper: Don’t choose a pillow or a very thin pillow under your head, but try to deviate from this sleeping style as it puts a strain on your neck and spine. Add a pillow under the belly to keep the spine from taking a U shape



The American Council on Exercise recognizes stretching as an effective way to reduce lower back pain, decrease muscle stiffness, and keep your back in alignment.

Regular, gentle stretching can also prepare your body for sleep. A small study shows that just four months of stretching can improve chronic insomnia symptoms.Another study found that gentle stretching was effective in promoting sleep health and was better than when participants did more strenuous exercises such as aerobics.


When to see a doctor

While back pain can be a normal event that goes away on its own, other times you’ll need medical attention, including:

  • The pain started with a specific injury
  • The pain lasts more than a few days or gets worse
  • Weaken pain
  • Pain radiates to the legs or other parts of the body
  • You feel weakness or numbness in your lower body
  • There are signs of infection such as redness, warmth, swelling, or fever
  • You have a personal history of cancer
  • You have other unexplained health changes, such as weight loss or urinary tract problems

If you notice new signs and symptoms of back pain after a period of remission (symptom-free status), contact your doctor.