Sciatica...Ice or Heat? How Often, When & Where?

​Heat or Ice…Which Is Better?  This is a common question I get from many of my patients regardless of where their pain or problem is.  So often that I wrote a blog about it several months back…you can read the full blog here.

Don’t worry I’ll do a quick review on the basics I covered in that blog, but today I’ll be going even deeper into this topic.  Why?  Because once you know if heat or ice is best for your situation, there are a few more questions that most people need answered to get the most benefit out of it, especially for those with something like Sciatica Pain. 

​Most people also ask things like how often should I use heat or ice?  When is the best time?  Where should I put it and for how long?

​Now if you have knee pain or elbow pain it makes sense you would put the ice or heat on your knee or your elbow, right?
But what if you have Sciatica Pain that starts in your back or your butt and runs all the way to your foot?  Where the heck do you put the ice or heat? 
 
Stick with me here!  All these questions are about to be answered so you can get the most benefit and best relief possible from using ice or heat.

A QUICK REVIEW
If you didn’t read my last blog yet, here’s the cliff notes version. 

Heat increases blood flow to the area to promote healing, helps decrease joint stiffness or muscle spasm, which in turn decreases pain and makes moving easier.  If this sounds like your problem, try heat.  

Ice can also help with muscle spasms and decreases swelling, which helps decrease pain.  If this sounds like your problem, try ice.  
 
Maybe you just need heat.  Maybe ice is better.  Or maybe you need both. 

Just choose the one that helps YOU feel better or alternate between both.  Your body will tell you if you got it right.  If you did, you’ll know because you’ll feel better.  If you try heat and it makes you feel worse, then try ice instead…and vice versa!  

It’s VERY important to remember that things like heat or ice can give you some TEMPORARY relief, but it will not fix the underlying problem causing your pain.  If pain persists for longer than 2 weeks, its time to get proper help to solve the problem.

Now that you know if heat or ice (or both) is best for you, let’s move on and answer the rest of your questions.  
   
HOW OFTEN SHOULD I USE HEAT OR ICE?
Well, it’s simple.  Use heat or ice as often as needed. 

If you’re in pain and heat or ice gives you some relief, use that to your advantage.  Obviously, less pain is a good thing.  Plus, being proactive and participating in some self-care can go a long way in speeding up your recovery process, while minimizing the need to rely on pain medications.

Heat and ice are just two of many self-care measures that can help you help yourself.  If you’re not sure what else you could be doing to support your body in a faster and more effective recovery, your Physical Therapist can help. 

WHEN IS THE BEST TIME TO USE HEAT OR ICE?
For the most part heat and ice can be used anytime you want or need some relief, but here are a couple things to keep in mind when it comes to timing your heat or ice.

Heat helps loosen up stiff joints and tight muscles.  So, if you’re stiff and aching in the morning heat can help get those stiff areas moving better.  Try using heat before stretching an area that is stiff or painful.  I find this helps make stretching the area easier, less painful and more effective. 

Ice on the other hand, makes things stiff and cold.  Stiff cold muscles and joints simply don’t move or stretch as easily.  For this reason, I generally recommend ice after activity, not immediately before.

HOW LONG SHOULD I LEAVE THE HEAT OR ICE ON?
In most cases, 10-15 minutes is adequate to have the desired effect on the area.  There’s no harm in leaving the heat or ice on longer if it feels good but you won’t necessarily get any additional benefit. 

Regardless of how long you keep the heat or ice on, it’s important to protect your skin from potential heat or ice induced burns.  Always check to make sure the temperature is comfortable and use a thin towel or pillowcase between your skin and your hot/cold pack for safety. 

SCIATICA PAIN?  WHERE SHOULD I PUT THE HEAT OR ICE?
This is a GREAT question and I see a lot of people with Sciatica Pain getting this wrong.  Why?   With Sciatica an irritated nerve in the lower back or in the buttock is usually where the problem stems from.  The irritated and inflamed nerve can cause intense pain, cramping, numbness or tingling to radiate into the thigh, calf, foot and sometimes all the way to the end of the big toe. 

It’s very common for this nerve pain in the leg or foot to cause the most discomfort.  Naturally we want to do anything we can to get some relief but putting heat or ice on your leg or foot simply doesn’t work.  Why?  Because the leg isn’t the problem.  It’s the symptom.  The source of Sciatica Pain is the irritated or inflamed nerve.  Focus on the source of the problem, the inflamed nerve in the lower back and/or buttock and you’ll have better results. 

Ice helps calm inflammation and is usually what I recommend anyone with Sciatica Pain try first.  But most people with Sciatica Pain also develop tight muscles, and in some cases it’s the tight muscles causing some of the nerve irritation.  Obviously, heat can help with the tight muscles.  So, you may get even more relief by alternating between ice and heat. 
Again, don’t fall into the trap thinking heat or ice will solve your Sciatica Pain, but it can help give you some temporary relief while you work with your Physical Therapist to identify and correct the root cause of your Sciatica.

I have seen the effects Sciatica Pain has on the lives of my patients.  It can be very frustrating and even debilitating for some.  I’ve had numerous patients who started out unable to walk or sit for more than a few minutes and feeling worried that this is their new life dictated by Sciatica Pain.  But it doesn’t have to stay that way.  I’ve watched those same patients get back to walking, running, dancing, etc.  Back to living a full life without limitation and enjoying the activities they love. 

If you’re ready to get some help for your problem and would like to find out more information about how we might be able to help you can get started by giving us a call at 503-744-0046 or CLICK HERE to request one of our FREE Discovery Visits. 

This will give you the opportunity to ask any questions you have, understand more about what’s causing your Sciatica Pain and what it might take to correct the problem.  There is no obligation and no cost.  Just few minutes of your time.  Afterward if you decide you want to move forward with treatment, we can discuss your next steps at that time.  If not, at the very least you will leave with a better understanding of your problem so you can make the best possible decision for yourself and your health moving forward.