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Heat or ice for sciatica? Which works better?

3 minutes, 49 seconds

Sciatica is a condition that occurs when the sciatic nerve is pinched, causing a pain that radiates out from the lower back through the hips and down the legs. Experts estimate that between 10% and 40% of people experience sciatica at some point during their lifetime. Symptoms typically last anywhere from one to six weeks, depending on the cause of the pinched nerve, although it can last longer or be a chronic condition for some people.

Like many musculoskeletal conditions, treating sciatica involves some combination of heat and ice, along with other forms of treatment. But which is better for sciatica, heat or ice?

Want to know whether heat or ice is the key to treating your sciatic nerve pain?

Keep reading to find out.

Does heat help sciatica?

Sciatic nerve pain typically stems from a herniated disc, bone spur, or strained muscle that swells and presses up against the nerve. While heat doesn't soothe the nerve itself, it can help to heal any injured bones or muscles around the nerve, which can relieve the pressure placed on it over time (not immediately).

When you apply heat to a body part, it causes the blood vessels in that area to widen, allowing more blood, oxygen and nutrients to flow to it. This blood brings with it white blood cells, which fight bacteria to prevent infection and swelling. It also contains nutrients that promote healing and regrowth in the injured area, which can help you recover from any injuries that led to your sciatic nerve pain.

However, it's important to note that heat actually aggravates the inflammatory process by sending increased blood flow to your lower back. By sending more fluid to the area around your sciatic nerve, you risk putting more pressure on the nerve and causing further pain.

Does ice help sciatica?

Ice slows the speed at which pain signals move through the nervous system, which can reduce pain. Sciatic pain won't spread as quickly to the other parts of your back and legs, and you can enjoy some pain relief, at least temporarily.

Ice also restricts the veins, which decreases circulation to the affected area. This limits the amount of blood that flows to and away from the area around your sciatic nerve, helping to reduce swelling in the bones and soft tissue in that area. If your sciatic nerve is being pinched by a swollen muscle, ice can help reduce swelling and take some pressure off your sciatic nerve.

Is heat or cold better for sciatica?

Ice can be an effective form of sciatica relief on its own, while heat is only recommended when used in conjunction with ice. Heat can actually increase the amount of swelling in your lower back, which can pinch your sciatic nerve even more than it already is and exacerbate your symptoms. Ice, on the other hand, reduces swelling and therefore relieves your sciatic nerve.

So whenever someone comes to us with the classic question about heat or ice for sciatica, we always go with ice.

Now, it's important to note that alternating heat and ice (known as contrast therapy) can be a more effective treatment method than ice on its own. Why? Because immediately applying heat after a period of ice application sends a much larger rush of blood flow to the area around your sciatic nerve. This ensures that white blood cells and nutrients are sent to the injury site to fight infection and promote healing without any unnecessary swelling.

So, consider alternating ice and heat on your injury for a few hours in 20-minute intervals. Make sure to end with ice to reduce swelling.

Other remedies for sciatic nerve pain

Unfortunately, there are no techniques that offer immediate relief for sciatic pain. However, there are some treatment techniques besides heat and ice for sciatica. Here are just a few of them:

  • Light exercise ” While you don't want to put your lower back under any significant pressure, walking or another light exercise can help to jog the muscles pinching your sciatic nerve.
  • Anti-inflammatory medication Ibuprofen and other NSAIDs can reduce inflammation in your muscles and remove some of the pressure from your sciatic nerve.
  • Physical therapy ” Many physical therapists specialize in treating sciatica. Your physical therapist will walk you through targeted stretches and exercises that can help relieve pain. They may also apply specialized techniques such as myofascial release, the McKenzie Method ® and dry needling to treat your symptoms.

Alliance PTP is ready to help you find top-notch PT for sciatica

At Alliance Physical Therapy Partners, we're proudly bringing together physical therapy practices across the country to help people get the high-quality PT they need. Want to see a physical therapist in person? We can put you in touch with an Alliance PTP partner that's close to you and that can help you address sciatica.

Not keen on in-person PT sessions or not close to an Alliance PTP partner? No worries. We also offer effective and affordable virtual physical therapy through our Agile Virtual Physical Therapy platform.

Contact our team today so we can help you find the most effective physical therapy services for your injury or condition.

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