Does ice have a role in managing sciatica? Every week in our clinic, we get patients asking if they should use ice to help sciatica.
Ice is an anti-inflammatory, and in most causes of sciatica, there is always an inflammatory component. Therefore, on the face, using ice seems to make sense because it would facilitate an anti-inflammatory effect.
The way it does this is by causing vasoconstriction: the ice makes the blood vessels to contract and narrow, resulting in lower blood flow. When something is damaged, you want to reduce the amount of blood flow to an area in the acute phase to stop any more bleeding or any extra fluid formation.
Therefore, it would appear that applying ice would be a worthwhile thing to do in the cases of sciatica. However, there are other key points to bear in mind.
First, the sciatic nerve is deep within the spine and is covered by ligaments and tissues. Therefore, the inflamed tissues are quite deep below the skin surface and there are many hard and rigid structures in between.
This means that the use of ice may not be as effective, since the inflamed tissues are deep beneath the skin, and therefore hard to get the temperatures reducing that deep down into the tissues.
Also, when you apply ice on the spine, you may get an increase in protective muscle spasms around the area of application. This can cause some shock to the system.
Nonetheless, there is a positive effect of ice, in that it generally numbs the skin over the area. Although the skin is not part of the problem, sometimes when the skin is numbed, you experience a beneficial effect of confusing the brain and hence reducing the severity of the sciatic pain.
There is definitely no danger or harm in applying ice. However, it is important to determine if you get any real benefits. It may feel better temporarily but it is unlikely to play a key role in the serious management of sciatica. In summary, there is potentially more benefit of ice than heat in acute sciatica situations but both of them are not potent tools in managing sciatica. While it may be tempting to try them, they may not have a significant effect on acute sciatic pain. You may feel better for a short while using ice, but you are probably better off in avoiding activities that provoke the nerve. Rather, make use of more potent anti-inflammatory measures which will be either oral or prescription anti-inflammatories from your GP.
