Tuesday, March 4, 2008

Using Heat to Relieve Sciatica

Over years of suffering on and off with sciatica, I've come up with various ways to deal with and eliminate the pain.

One of the first things I do when I dealing with a bought of sciatica is treat the pain with heat. It always works.

Whenever you're in pain, you always have the option to treat the injury with heat or cold. In the case of sciatica, and any other nerve related pain, heat is far superior to cold because of its soothing effect on nerve endings and the relaxing effects it has on your muscles around the nerve pain. Try these ways of using heat to relieve your sciatic pain.

At night, lay in bed or on the floor with a heating pad under your hamstring and low back (or wherever the pain is acute.)
Be sure to have knees bent with both feet flat and equal weight in each foot. Let both sides of your lower back drop into the mattress with equal weight. After a while, you might feel like you should move the pad to a different place, or lay on your side on the pad, and you should. Just be sure to turn off the pad after about 20-30 minutes so you don't burn yourself in the middle of the night.
If your pain is a lower part of your leg, try to wrap the heating pad around the painful area. The most important things, other than bringing heat to the sore spots, is that your back is supported (knees bent) and your weight is distributed evenly throughout your whole body. This means that you can scrunch yourself up into a little ball in bed with a warm heating pad draped over your leg and expect to feel better the next day!

Another source of heat is the shower.
I can't say I recommend a bath because I feel that the seated position in the bathtub is counterproductive to relieving sciatica. Standing up in the shower takes a lot of pressure off the nerve and the low back.
In the shower, let hot water drum on the painful spots. At the same time, purposefully relax the area where the water is hitting. Let all those muscles feel like jelly. Soften your knees, ankles, and hip creases so your legs aren't locking to hold you up. Once you're able to do this, you might start to feel very small muscle spasms where the water is hitting you, as if muscle tension is letting go.

You'll notice that the underlying notion behind both of these methods of applying heat is that you need to relax the muscles around the pain as well. The best way to relax your muscles when you're dealing with sciatica is to place yourself in positions where your body is in good alignment with support to your back and with your weight in both feet.

Good luck!


Melissa said...

I found that heat makes sciatica much worse. My doctor explained that heat causes the blood (and oxygen) to move away from the injury, where cold draws the blood to the injury, thus expediting the healing process. Against his advice I soaked in a hot bath because it felt good on my muscles, but the next day I could hardly walk.

Heads Up On Your Body said...

Hi Melissa,
I'm sorry that your sciatica got worse! It may have been in part due to the fact that you took a bath, and the position your body was in. Like I wrote in the post, baths are not good for sciatica because a)you're sitting, b)your legs are straight out in front of you, and c)you don't have any lumbar support, so you rounding in the low back.
I assume that is how you were sitting, but of course I could be totally wrong.

Here's what the Mayo Clinic has to say about cold or hot packs for sciatica:

"Cold packs: Initially, your doctor may suggest using cold packs to reduce inflammation and relieve discomfort. Wrap an ice pack or a package of frozen peas in a clean towel and apply to the painful areas for 15 to 20 minutes at least four times a day.

Hot packs: After 48 hours, apply heat to the areas that hurt. Use warm packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs."

Unfortunately, sciatica is so damn unpredictable! Everyone is different. If you find that cold works better for you, that's great, and you should use cold packs instead. Its my personal experience that using a hot pack is best, but again, that's just me and my finicky sciatic nerve!

Thanks for posting about your experience, anything we can share about sciatica will help other people with the same problem. :)

Sandra said...

I have times when I can not find any position that brings relief and it has been right side oriented. When it's really bad, I've found relief from laying in the tub on my left side with my right arm over the side and my chin on the side with the water from the shower beating down AND filling the tub while I regulate my breathing - breathing into the area of hurt and focusing on relaxing the muscles has helped to ease it. When it is in that much flare I am not comfortable standing and it turns into a pull up behind my waist and aches down to my ankle. Possibly, I will put an ice pack on when I get out depending on how it feels in the moment.

Heads Up On Your Body said...

Sandra, I'm so sorry that you have to go through such lengths to relieve your sciatica pain. But it sounds like a great thing to try for anyone who has pain from standing.

I think one of the most important thing you said was that you focus on breathing into the area of pain and relaxing the muscles around the nerve. Breathing, focusing, and relaxing are all so important. Its tempting to grimace and moan in agony but those will just make the pain worse!

Thanks for sharing your tactics, hopefully your ideas will help other people with the same problem.

Anonymous said...

I thought it might be of use to clarify what happens when we use hot verse cold.

The explanation Melissa's Dr. gave her was either mixed up/reversed in her rememberence of it, or, dare I say, the Dr. was incorrect. No fault of Melissa of course.

For clarity sake here's the basics of it. Cold is used immediately after injury, at times, to reduce inflammation, inhibit/over-ride the pain receptors and constrict local blood vessels. The constriction of vessels causes a decrease in circulation to the area and constriction of the tissues caused by the cold temp. disperses the fluids associated with the inflammation. The blood vessel constriction also helps to reduce bruising by narrowing the capillaries and limiting the perfusion of blood into the surrounding tissues.

On the other hand, heat will dilate blood vessels (make wider/open up) causing an increase of circulation to the region. More blood, thus more oxygen and more nutrients... and more immune cells to assist in the repair of locally damaged or compromised tissues. Consequently, if there is inflammation it will enhance the swelling by allowing more fluid into the region.

This is why we often here of using the two together. 1 -2 minutes of ice followed by 5 minutes of heat and repeat for 20 - 30 minutes. The ice will disperse the local swelling, forcing out metabolites/cellular waste that gets built up. The heat will then draw in fresh blood carrying the vital oxygen, nutrients and immune cells necessary for repair.

It sounds like Melissa's Dr. or she herself got them mixed up.

Now if you use heat on an inflamed nerve you're likely to increase the flare up because you're bringing in more fluid/blood and increasing pressure around the nerve. If the pain is from an inflamed nerve then ice is best temporarily. If the source of pain is from a tight muscle constricting the nerve then heat would cause a relaxation response of the muscle and provide relief from pressure on the nerve.

Hope that helps.

Heads Up On Your Body said...

Thanks for all your thoughts on this subject. The funny thing for me personally has been that using heat on my hip, butt, or leg has always been one of the key things that help relieve my sciatica when it flares up. I know that contradicts the fact that heat brings blood to the area and would cause more inflammation. But the fact is, it really works for me!

The only possible explanation I can come up with off the top of my head, is that the heat is "relaxing" the tight muscle or muscle spasm that is pinching my nerve. Or, maybe the muscle feels as though it can relax when it is warm.

When sciatica flares up, the thought of putting ice on the sore area sounds like agony!

I'd just be curious to hear if anyone else out there has had a similar experience, that would be interesting to hear about. Or maybe my body is just freakish!

Anonymous said...


Yes, that makes sense. You're body is not "freakish", no more than the next persons... :)

As I mentioned in the previous post:
"If the source of pain is from a tight muscle constricting the nerve then heat would cause a relaxation response of the muscle and provide relief from pressure on the nerve."

In this case you're right, ice would be the last thing you'd want to use as it would only tighten the muscles further. A nerve doesn't always become inflamed from the tight muscles putting pressure on it. If it persisted for long enough it certainly could.

But the example you give of yourself is a good one because it shows that we can sometimes narrow down the nature of the sciatica through safe self-care methods. If you used ice and it bothered it more then that would be a likely indication that you're looking at constricted musculature creating the problem. Then you might ask, 'Well. why is the musculature contracting in such a way? What is causing this muscular response?' ...And then go from there... always asking 'why', as there is usually always a reason.

Heads Up On Your Body said...

Well put!

Makeup Fun With Jessie said...

I'm lying in bed with a HEATING pad :) on my back right now. I have a buldging disk in my back that sometimes pinches the root nerve which is excrutiating. Having the piraformus muscle tight or enflamed does not help the situation, so....Not knowing what the heck to do. I mostly am comforted by the heat. Doing some yoga positions that stretch out that muslce also hurt at first but eventually helps. Even though I decided to stay in bed today I am trying to stretch while in bed. It just takes time, a lot of time, days sometimes weeks. I think being more mobile than not helps. I am considering surgery. I have had this for about 5 years now (it's not always spasing) but I never know when it's gonna flare up and take over my life. I would love to hear anyone's thoughts on surgery, if they have had it, if it worked, etc?

Heads Up On Your Body said...

Hi MakeUp Fun,
Sorry you've been in pain for 5 years, that's a long time to live like that. I can understand why you'd be considering surgery at this point but I have to beg you to exhaust all other options before surgery. Spinal surgery should be your absolute last resort, it can cause so many other problems and not even make your pain go away on top of that.

Of course, if anyone has experience with surgery and would like to share, it would be very interesting to hear.

Did you get an MRI to diagnose the bulging disk? What is your profession? What have you already done besides the yoga stretches to help/heal your pain? Do you know what caused the disk problems in the first place?

If you let me know some of the answers, I can try to suggest things other than surgery that could help you.

jxnfan said...

I have had a recurring problem for a few years. Right hip pain that usually resolves itself in a week or so. Previous doctor visits ruled out joint problems, and the remedy was stretching. This recent time, however, it has interfered with my ability to lie down in any position, resulting in lack of sleep for a week.

At the doctor's office, the nurse said no heat at all, even avoid hot water on the area in the shower. She recommended the tennis ball exercises (which no one here has mentioned.) The doctor recommended heating pads, hot showers, etc, and said not to use the tennis ball while inflammation is present. Any thoughts on who is right???

Heads Up On Your Body said...

Hi jxnfan,
That sounds terrible. I recommend you get a second opinion as to what the problem is from another doctor, and visit an osteopath. Stretching most likely is making the problem worse. Also, improper stretching will make it much, much worse.
As far as the heat/no heat issue, have you tried heat, and has it helped? If it does help, then I would say just do it. The tennis ball could make things worse, I never recommend tennis balls. Instead, try rolling your leg on a foam roller. You'll need to work with a pilates instructor or someone who knows how to use it properly, but it could help a lot.
Good luck.