Have you been experiencing pain, numbness, or tingling in your back and legs?
Then you might have sciatica.
Sciatica refers to pain along the sciatic nerve distribution which runs from the lower back into the buttocks, leg, and foot.
Symptoms may include pain, numbness, tingling, and tightness throughout the lower back and affected leg. One of the many treatments for sciatica is the use of ice and heat. Both hot and cold therapies are effective methods for treatment and will be discussed in this article.
When is heat useful for treating sciatica?
Heat is an excellent treatment modality for chronic pain as promotes healing and can decrease pain signals. After the initial onset of sciatica, when the sharp pains subside, heat may be beneficial to apply to the low back and buttock regions.
The heat will help stimulate blood flow in the area and loosen any tight musculature that may be contributing to the sciatic symptoms.
If sciatica is caused by chronic low back pain, disc herniation, or stenosis, heat may be a better treatment option as it can relax the structures around the compressed nerve roots and improve blood flow to the area.
Heat can be placed directly at the low back/buttock region or slightly above for the best effects.
Can heat make sciatica worse?
In some cases, heat can worsen sciatic symptoms when applied directly to the nerve roots in the low back as it increases nerve conduction and can cause symptoms to become more severe.
Everyone is different, so you may need to try heat in several different places until you find one that works for you.
Types of Heat Therapy for Sciatica
Heat can be applied as a dry heat or as a moist heat. Both are effective at warming tissue in a particular area but they work a bit differently from each other.
Dry heat, such as an electrical heating pad, can be used for quick heat relief. It typically does not get as hot as moist heat and can be used to transfer heat slowly into affected tissue.
Moist heat, such as moist wraps or hot baths, also provides pain relief but at a higher temperature than dry heat. This can quickly heat up the tissue for a more immediate relief.
In either case, heat should not be applied longer than 20 minutes at a time as it can cause damage to the tissue.
Read Related: Best Heating Pads for Back Pain Relief
When is ice useful for treating sciatica?
Ice is the best modality to reduce inflammation and swelling. It works by constricting blood vessels and decreasing circulation to the injured area.
It is often used within the first few days after an injury and is very effective at reducing pain. In the case of sciatica, ice can reduce compression to the nerve as well as slow nerve conduction, so the symptoms do not feel as intense.
If sciatic is caused by general low back pain, trauma, or tightening of the surrounding musculature, ice may be a better treatment.
Applying ice to the low back/buttocks region will likely provide the most relief as it can directly impact the nerve roots. In my experience, patients with overactive sciatic nerves have tolerated ice therapy much better than heat.
Ice should be used in 15–20 minute intervals and can be performed repeatedly throughout the day.
Ways to Relax the Sciatic Nerve
While ice and heat are great modalities for pain relief, they are not the only way to address sciatic symptoms.
Performing sciatic nerve glides, lower trunk rotations, and piriformis stretches will address the causes of sciatica for longer lasting relief.
(Youtube Video) Supine Piriformis Stretch for Sciatica & Lower Back Pain
For best results, I always recommend my patients perform their stretching routine while laying on an ice pack to help combat any soreness or discomfort that may occur during the stretches.
Frequently Asked Questions
Are hot tubs or baths good for sciatica?
Moist heat can help quickly heat tissues and reduce pressure to the sciatic nerve.
Many people feel better after soaking in a hot tub or bath as it helps relax their muscles, but it is important to follow any use of heat with stretching to maintain the results.
2. Is Icy Hot good for sciatica?
Icy hot, biofreeze, and cryoderm are 3 topical gels people often turn to for pain relief.
They contain various amounts of menthol which produces a cool, tingling sensation to help alleviate muscular pain. It can be helpful in reducing sciatic symptoms.
3. Is infrared heat good for sciatica?
Infrared heat can be used to stimulate blood flow and healing which can aid in reducing sciatic symptoms.