While it may seem logical to apply heat to the area where your sciatica feels worst—like the back of your thigh or your calf, these areas are not the source of your pain. Sciatic nerve pain originates from your rear pelvis and the lower back, and heat therapy works best when applied to this region.
Heat therapy is easily available, simple to use, and can provide immediate relief from the shooting sciatic nerve pain in your leg—read on to learn how.
Apply heat to your rear pelvis
As a general rule, it is best to apply heat therapy to your rear pelvis—the area where your sciatic nerve roots (the spinal nerve roots L4 to S3 1 Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/. that branch off the lower spinal cord) originate. You feel sciatic nerve pain, numbness, and/or weakness when one or more of these nerve roots become inflamed, irritated, or compressed. The symptoms then travel down your leg along the path of the long sciatic nerve. 2 Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/.
The symptoms of sciatica may be relieved or reduced, almost immediately and effectively, by the soothing effect of heat on the lower back.
Heat therapy encourages healing in sciatica
When you apply heat to your rear pelvis, it typically 3 Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2014;127(1):57-65. doi:10.1080/00325481.2015.992719 , 4 Lowe W, Chaitow L. Thermal modalities as treatment aids. In: Orthopedic Massage. Elsevier; 2009:27-42. doi:10.1016/b978-0-443-06812-6.00003-9 :
- Causes your blood vessels to dilate and supply more blood, oxygen, and nutrients—promoting healing
- Decreases tension and spasm in your muscles, which contributes to pain, by relaxing your muscle fibers
- Reduces the tightness in painful muscles and increases the range of motion of your lower back
Heat therapy helps break the pain-spasm-pain cycle, where pain causes your muscles to spasm as a protective response, and those spasms, in turn, cause more pain. 4 Lowe W, Chaitow L. Thermal modalities as treatment aids. In: Orthopedic Massage. Elsevier; 2009:27-42. doi:10.1016/b978-0-443-06812-6.00003-9
Easy-to-use heating aids
Several heating aids are available, which you can use at home, while driving, or at work. Here are a few simple options:
- At home, you can use a hot water bottle, heat patch, or an electric heating pad. You can also wrap an electric heating blanket around your lower back and abdomen for a more closed heating effect. 5 Dehghan M, Farahbod F. The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study. J Clin Diagn Res. 2014;8(9):LC01–LC4. doi:10.7860/JCDR/2014/7404.4818
- While driving, you can use self-adhesive heat patches that activate when in contact with the body.
- In the office, try long-lasting, low-level heat wraps that adhere to the skin and can be worn under the clothing during the day for a continued heating effect.
Newer techniques include using heat from infrared radiation, which can be obtained from pads, mats, or clothing. While some of these materials need an external power source, others emit infrared radiation by activation through body heat. 6 Tsai SR, Hamblin MR. Biological effects and medical applications of infrared radiation. J Photochem Photobiol B. 2017;170:197–207. doi:10.1016/j.jphotobiol.2017.04.014
If your sciatica pain recurs often, try keeping a heating pad near your bed, which you can use as soon as you wake up. By loosening your tissues and improving your blood circulation soon after waking, you can prevent sciatica from starting or flaring once you get up and begin to move around.
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Warnings and precautions while using heat therapy
When using heat therapy, the heat source should be warm, as tolerated, and not hot. As a general rule, heat therapy can be used for 15 to 20 minutes, with breaks in between to avoid skin damage. Overuse of heat therapy may cause burns, scalding, or ulcers. It is a smart idea to place a cloth barrier between your skin and the heat source (unless the heat source is a patch designed to stick to skin). It is also advisable to avoid laying directly on the heat source to prevent trapping of additional heat and potentially causing skin damage or permanent changes in skin color.
If you have specific medical conditions, such as multiple sclerosis, poor circulation, spinal cord injuries, diabetes mellitus, and/or rheumatoid arthritis, it is advised to avoid heat therapy. Heat in these conditions may cause excessive burns, skin ulceration, and/or increased inflammation. 3 Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2014;127(1):57-65. doi:10.1080/00325481.2015.992719
Bonus tip: Stretch after using heat therapy to strengthen your lower back
While heat therapy may help you find quick relief from your sciatica symptoms, it is best used as part of a broader treatment plan that typically includes stretching and other targeted exercises.
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When you experience pain relief after using heat therapy, try to perform simple lower back stretches. Stretches and targeted exercises can help prevent sciatica from recurring, by relieving the sciatic nerve compression, strengthening your tissues, and improving the flexibility in your lower back.
Use these tips today to see if the benefits of heat treatment help improve your sciatica symptoms. For long-term pain relief, add an exercise program or regular walking to your everyday routine.