Should I use Ice, Heat or Both for Sciatica Pain? | Hot vs Cold Therapy for Sciatica Pain

Updated: May 7

Heat or Ice?

The question I get most from any client is this:


“Should I use heat or ice for my __________ problem?”


The easy simple answer is “Yes”, but obviously there is much more to it than that.


I encourage my clients with sciatica pain or piriformis syndrome to use ice for the first 2-3 days after initial onset of pain, to the low back or butt respectively. The ice should be applied for 10- 15 minutes at a time, 2x/ hour. This gives the area a chance to warm up and restore normal blood flow, therefore oxygen into the area to help promote healing, while at the same time, keep inflammation to a minimum.

Years ago, constant (R.I.C.E.) rest, ice, compression and elevation to an injured area, sprained area or region was highly touted as the way to quicker healing. But, more recent studies show that constant icing, decreases the oxygen in the injured area and this does not allow healing to begin, so the constant icing of olden days is no longer pushed.

Heat should be used after the 3rd day, or whenever the issue feels tight and stiff for no reason. This means you did not overdo activities or aggravate the problem in anyway, but is just stiff/sore and achy for no particular reason except it is not fully healed yet. With what I just said above, there are reasons why one may not want to follow this advice.

First, if you are one who cannot tolerate ice, or it just has no positive effect for you, feel free to only use heat.

Second, if you are one who cannot tolerate heat for any reason and when you try to use it, it only causes more aggravation and swelling and you do not benefit from it, feel free to only use ice.

There are some people who love both ice and heat and if that is you, I suggest you alternate icing and heating. Most people seem to use ice for 10-15 minutes, followed immediately by heat for 15 minutes. This combination seems to work very well and you get the calming, numbing, swelling reducing and pain alleviation benefit of ice, followed by the relaxing, calming and healing oxygen flow of the heat. Repeating this every hour gives many of my client’s relief, which is always welcome when dealing with sciatica pain or piriformis syndrome. Sciatica and piriformis syndrome are very difficult dysfunctions to overcome, but with the right balance of activities, ice/heat and motions, they are very defeatable!


Please feel free to reach out with any questions to info@SciaticaReliefNow.net.

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