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Heat Or Ice For Sciatica, Which Is Better? + 3 Exercises For Relief

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Sciatica can cause extreme pain in your lower back, glutes, and/or leg. In some cases, it can make it impossible to sit, stand, or run.

You will have likely heard conflicting opinions when it comes to which treatment protocol you should utilize. Both heat and ice can be used to relieve sciatic pain, but they serve different purposes and have different theories underpinning their efficacy.

Applying ice packs can help reduce inflammation and numb the area, providing temporary pain relief. Heat, on the other hand, can help relax tense muscles and improve blood circulation. Some people find alternating between heat and ice therapy beneficial.

So, heat or ice for sciatica? Let’s break down what the science says, equipping you with up-to-date information to make the right decision.

In this article, we will cover:

  • What Is Sciatica?
  • Heat Or Ice For Sciatica: Benefits Of Ice
  • Heat Or Ice For Sciatica: Benefits Of Heat
  • Is Heat Or Ice Better For Sciatica?
  • 3 Effective Exercises For Sciatica
  • Heat Or Ice For Sciatica: Final Thoughts

Let’s dive in!

A person holding their back due to pain from sciatica.

What Is Sciatica?

Sciatica can be a real pain—literally!

It happens when the sciatic nerve, the largest nerve in your body, gets compressed. This nerve starts from the lower back’s spinal cord, goes through the gluteal muscles, and runs all the way down the back of your legs to your foot.

Sciatic pain can occur anywhere along the nerve’s path and can radiate outward along the entire nerve course.

And that’s not all! Since sciatica is all about nerve compression, you might experience more than just pain.

Your sciatic nerve is responsible for controlling movement, so weakness in the affected leg or difficulty moving it can also come into play. And don’t be surprised if you feel some numbness and tingling too.

An ice pack strapped to a person's back.

heat or ice for sciatica: Benefits of ice

Early-stage sciatica can benefit from cold therapy. The general recommendation is to utilize cold therapy within the first 48 to 72 hours of experiencing symptoms.

Cold therapy can effectively reduce intense pain and inflammation that often accompanies nerve-related injuries.

Cold therapy works by achieving two key effects:

  1. Firstly, it decreases nerve conduction, providing relief from sharp pain and sensitivity caused by nerve injuries. Nerves transmit electrical impulses to enable feeling and movement. Cold treatment helps suppress these signals, offering comfort.
  2. Secondly, cold therapy reduces blood flow to the affected area, resulting in numbness, which aids in pain relief. When the body is exposed to low temperatures, your blood vessels will constrict, thus reducing the flow of warm blood to the skin to preserve body heat. This reaction leads to diminished circulation and numbing sensations.

How To Apply Ice

For the best results, cold therapy should be applied to the lower lumbar portion of the spine, where the sciatic nerve is located.

You can choose from a variety of different options, from ice packs to a packet of frozen vegetables.

Apply them three times a day for 15 to 20 minutes.

It’s essential to avoid overusing cold therapy, as it can lead to skin damage or superficial nerve damage.

A person in a sauna.

Heat Or Ice For Sciatica: benefits of heat

Let’s delve into how heat therapy can benefit you.

Heat therapy works by achieving two key effects:

  1. Heat therapy is known to increase circulation. This increased circulation helps remove damaged cells while delivering oxygen and essential nutrients to support the healing of wounded soft tissue.
  2. Heat therapy can increase tissue metabolism, soothing stiff muscles and reducing painful muscle spasms. Heat dilates blood vessels, leading to improved circulation. This, in turn, allows injured tissues to metabolize the nutrients from the increased blood flow.

How To Apply Heat

There are two main methods for heat applying heat. Dry heat involves using heat pads, hot water bottles, etc. On the other hand, you can utilize moist heat such as warm baths.

Choose the method that works best for you. Depending on the extent and location of your sciatica pain, you can apply heat therapy in a specific area or more generally.

For smaller areas of pain, like a stiff lower back, you can opt for local heat therapy using a heat patch.

If your sciatica pain extends over multiple areas, full heat therapy can be beneficial. You can achieve this by spending time in a sauna or taking a warm bath.

It’s advisable to stick to 15 to 20 minutes per session when applying heat therapy as a runner managing sciatica.

A person holding an ice pack on their back.

Is heat or ice better for sciatica?

So, ice or heat for sciatica? Both heat and ice have their benefits, and both offer a great tool for reducing pain experienced by sciatica.

Whether you choose to use heat or ice will depend on individual preferences and the stage of sciatica you are experiencing:

  • In the acute phase of sciatica, when inflammation and sharp pain are prominent, ice therapy may be more beneficial. Applying ice packs for short periods can help reduce inflammation and provide pain relief.
  • As the acute phase subsides and the pain becomes less intense, heat therapy might be more suitable for some individuals. Heat can help relax muscles and improve blood circulation, potentially providing comfort and easing muscle tension associated with sciatica.

In my clinic, I would often recommend clients try alternating between heat and ice therapy to be effective, depending on their symptoms and preferences. Ice or heat for sciatica? Why not both?

For example, using ice therapy during flare-ups with increased inflammation and switching to heat therapy during periods of muscle tension and stiffness.

It’s essential to listen to your body and pay attention to how it responds to each therapy.

If you have any doubts or concerns about which therapy to use or if your sciatica pain persists or worsens, consult with a healthcare professional for personalized advice and recommendations.

They can help determine the most suitable treatment plan for your specific condition.

A therapist stretching a patient.

3 effective Exercises for sciatica

Alongside heat and ice, a rehab plan should include movement.

It’s important to note that not all movements may be suitable for individuals with sciatica, as certain exercises or activities could worsen the condition.

If you are in the acute stage of a sciatic flare-up, rest may be necessary to allow the inflamed tissues to heal before gradually introducing movement and exercise.

However, after the acute phase has ended, gentle movement and stretching can help relax tense muscles around the sciatic nerve.

If the muscle in the lower back is too tight, it can put pressure on the nerve; movement can help to release this tension and alleviate pressure on the nerve.

Exercise will also lead to an increase in blood circulation, facilitating the delivery of oxygen and nutrients to the tissues. Improved circulation also aids in removing waste products and inflammatory substances, aiding in the healing process.

If any exercise hurts, stop. Try and make it easier by reducing the range of motion, load, or time under tension.

If an exercise continues to hurt, it’s advisable to consult with a healthcare professional or physical therapist for personalized guidance and adjustments to the exercise.

Below we will detail three exercises and stretches for you to try!

#1: Rockbacks

Child's pose.

Rockbacks stand out as an excellent exercise for easing sciatica pain due to their capacity to stretch and alleviate compression in the lower back.

By doing so, they contribute to safeguarding your spine, promoting proper alignment, and enhancing movement mechanics.

To perform rockbacks:

  1. Begin in a tabletop position with a flat back, supporting your weight on your hands and knees.
  2. Then, gently shift your weight towards your hands while simultaneously sitting your hips back towards your heels, resembling a child’s pose in yoga.
  3. Maintain this motion of rocking backward and forwards in a slow and controlled manner, repeating the movement 10 to 12 times.

#2: Sciatic Nerve Glides

Leg stretches on the grass.

This sciatica stretch aims to improve the mobility of the sciatic nerve by facilitating smooth gliding within its surrounding tissues.

By doing so, it helps to prevent further irritation and compression, promoting optimal nerve function.

To perform this stretch:

  1. Begin by lying on your back. Flex the hip and knee of the affected leg to 90 degrees, aligning your kneecap with the ceiling and keeping your shin parallel to the floor.
  2. Next, grasp the back of your thigh with your hands, securing a firm grip.
  3. Throughout the stretch, maintain your ankle in position by pointing your toes toward your nose.
  4. Now, gradually straighten your knee while paying attention to the sensations along the back of your leg. You should feel a gentle stretch in the area. Hold this position for a comfortable duration.

Remember to perform this stretch slowly and gently, and avoid pushing yourself beyond your comfort level.

#3: Bird Dog

Bird dog exercise.

Bird dog is a beneficial exercise that aids in elongating the sciatic nerve along its path while also strengthening the spinal stabilizers and deep core muscles.

To perform the bird dog exercise:

  1. Begin by kneeling on all fours in a tabletop position, ensuring your back is flat, and your core is engaged.
  2. Inhale deeply, then simultaneously lift your right hand and left knee off the floor, bringing them together under your torso to touch.
  3. Exhale as you extend the same arm and leg, straightened in front of you and behind you, respectively.
  4. Execute each movement slowly and with control, completing 12 repetitions on each side.

By incorporating bird dogs into your routine, you can target the sciatic nerve, strengthen your spinal stabilizers, and enhance core muscles for improved stability and support.

A doctor checking a patient's back.

heat or ice for sciatica – final thoughts

The bottom line is that more high-quality research is needed in order to confidently say whether heat or ice is better for sciatica.

Therefore it is hard to draw firm conclusions about the effectiveness of cold and heat therapies for sciatica.

That said, both heat and ice have their benefits, as mentioned above, and they can be fantastic tools to utilize if you are suffering from sciatic pain.

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Ben is a qualified Personal Trainer and Sports Massage Therapist with a particular interest in running performance and injury. He has spent the last 9 years working with runners at his clinic in Brighton. Ben is a keen runner and avid cyclist. Evenly splitting his time between trail running, road biking, and MTB.

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