Sciatica is a condition characterized by pain that radiates along the path of the sciatic nerve, which branches from the lower back through the hips and down each leg. The pain is often caused by pressure or injury to the sciatic nerve. Many people use topical creams and gels like deep heat rubs to try to relieve sciatica pain. But is deep heat rub actually effective for sciatica? Here is a comprehensive look at the research on using deep heat rub for sciatic nerve pain.
What is Sciatica?
Sciatica refers to pain caused by irritation or compression of the sciatic nerve. The sciatic nerve is the longest and widest single nerve in the human body. It originates in the lower back and runs through the buttocks and down the legs. Along its path, the sciatic nerve branches out to supply sensation and strength to the legs and feet.
Sciatica pain typically radiates from the lower back, through the buttocks, and down one or both legs. The pain is often described as sharp, shooting, or burning. Other symptoms can include:
- Numbness or tingling in the legs or feet
- Muscle weakness in the affected leg
- Difficulty moving the leg or foot
- Constant pain that increases with prolonged sitting
The most common cause of sciatica is a bulging or herniated disc in the lower spine. A herniated disc puts pressure on the nerve roots that form the sciatic nerve. Other causes can include:
- Spinal stenosis – narrowing of the spinal canal
- Spondylolisthesis – slippage of one vertebra over another
- Piriformis syndrome – tightness of the piriformis muscle in the buttocks
- Injury to the lower back, often from heavy lifting or a motor vehicle accident
- Tumors or cysts putting pressure on the sciatic nerve
Treatment Options for Sciatica
For most people, sciatica will resolve on its own with time. Initial treatment focuses on relieving pain and preventing progression of the condition. Common options include:
- Over-the-counter pain medications – Anti-inflammatories like ibuprofen can help reduce inflammation and relieve discomfort.
- Hot and cold packs – Alternating hot and cold compresses may alleviate pain and muscle spasms.
- Gentle stretching and exercise – Low impact activities can help strengthen muscles and improve flexibility.
- Steroid injections – Epidural steroid injections around the spine may help decrease inflammation.
- Topical analgesics – Creams and gels like deep heating rubs may provide temporary relief when applied to painful areas.
For persistent or severe cases, additional treatments may be warranted. This can include more intensive therapies like spinal manipulation, prescription medications, and surgery in rare cases.
What is Deep Heat Rub?
Deep heat rubs are topical creams, gels, and ointments that produce a warming sensation when rubbed into the skin. They are marketed as analgesics (pain relievers) and are commonly used to treat muscle and joint pain.
The active ingredients in deep heating creams depend on the specific product but generally include:
- Capsaicin – Extracted from chili peppers, capsaicin warms the skin and interferes with pain signals.
- Cinnamon oil or mint oil – Causes mild heating and cooling sensations.
- Menthol – Triggers a cooling effect.
- Camphor – Produces feelings of warmth.
- Methyl salicylate – Provides a warming sensation and has anti-inflammatory effects.
These ingredients are thought to work in several ways:
- They overwhelm nerve endings with hot and cold sensations to temporarily reduce pain signaling.
- They stimulate blood flow to the area which promotes healing.
- Some ingredients like methyl salicylate have anti-inflammatory properties.
- The menthol provides a cooling effect that soothes aching muscles.
The warming or cooling sensations begin shortly after massaging the deep heat rub into the skin and can last for up to several hours.
Can Deep Heat Rubs Help Relieve Sciatica?
There is limited quality research on the efficacy of deep heat rubs specifically for sciatica pain. However, some studies have looked at using topical rubs for general nerve and musculoskeletal pain.
Here are some of the potential benefits found in studies on using deep heating creams and gels topically for nerve and muscle pain:
- One study found that a cream containing capsaicin helped reduce neuropathic pain and improve overall quality of life compared to a placebo cream.1
- In another study, massaging ginger oil that produces a warming sensation into the skin significantly reduced muscle pain after exercise compared to massage without the oil.2
- Methyl salicylate rubs may help relieve muscle soreness and minor arthritis pain according to some studies.3
- Menthol gels have been shown to have a mild analgesic effect on nerve pain.4
- Topical creams may be beneficial alternatives for pain relief for those who cannot tolerate oral NSAID medications.5
This research suggests deep heating rubs could potentially help alleviate some of the pain and discomfort associated with sciatica. The warming sensation distracts the nerves and may interrupt pain signals. Increased blood flow could also reduce inflammation around the compressed nerves.
Potential Risks and Side Effects
However, there are some potential risks and downsides to using deep heat rubs for sciatic nerve pain:
- The evidence for effectiveness specifically for sciatica is lacking.
- Results from studies are mixed, with some showing little benefit for nerve pain.
- The warming sensation is temporary, lasting only while the rub is on the skin.
- Some people may be allergic or sensitive to ingredients like methyl salicylate.
- Overuse or applying too vigorously may further irritate sensitive tissues.
- May not be as effective for severe or chronic nerve compression.
More research is still needed on using topical rubs for treatment of sciatic pain in particular. Deep heat rubs are likely only to provide mild, short-term relief rather than treat the underlying cause of the sciatica.
What the Research Says
There are very few studies looking specifically at deep heat rubs for sciatica. But here is a summary of some relevant research on using topical creams and gels for nerve pain:
- A 2010 study found a methyl salicylate and menthol rub provided significant relief of muscle aches and pain compared to placebo. It was as effective as topical diclofenac gel.6
- A double blind, randomized study in 2015 saw no benefit of using a topical methyl salicylate/menthol rub for knee arthritis pain versus placebo gel.7
- A 2017 review of 4 studies found creams containing capsaicin, the active component of chili peppers, were somewhat effective for various neuropathic pain disorders.8
- Another review looked at 17 trials using topical capsaicin for nerve pain. It concluded capsaicin creams provided modest pain relief but effects were slow to occur.9
Overall, there is limited evidence that deep heating rubs relieve nerve-related pain better than placebo treatments. Some studies show mild benefits while others show no difference compared to control groups. More large scale, high quality studies are still needed specifically looking at sciatica.
Tips for Using Deep Heat Rubs for Sciatica
While more research is still needed, some people do report benefits from using deep heat rubs for sciatic pain. If you want to try using a heating cream or gel, here are some tips:
- Choose products containing proven ingredients like menthol or capsaicin.
- Massage a small amount directly over the areas of sciatic pain.
- Avoid using on broken skin or irritated areas.
- Do not wrap or bandage tightly over the rub.
- Start with short applications of 10-15 minutes to test for any skin reaction.
- Avoid use if you are pregnant or have poor circulation.
- Stop using if skin becomes very red or inflamed.
- Consider alternating with a cold compress to avoid skin irritation.
- Discuss with your doctor if you have health conditions or are taking medications.
Proper usage guidelines should be followed to get any benefits from topical rubs while avoiding potential risks or side effects.
Other Ways to Manage Sciatica
While deep heating rubs may provide some temporary relief, they do not treat the underlying cause of sciatica. Here are some other evidence-based ways to manage sciatic nerve pain:
Oral OTC pain relievers like NSAIDs (ibuprofen, naproxen) or acetaminophen can help reduce inflammation and discomfort associated with sciatica.
Stretching and Exercise
Specific stretches and low-impact exercises can help strengthen the back and improve flexibility, taking pressure off the compressed nerves.
Heat and Ice Therapy
Applying hot packs or cold compresses directly to the lower back may alleviate pain and muscle tension.
Massage techniques like trigger point therapy may help relax tight muscles putting pressure on the sciatic nerve.
Some research indicates that acupuncture can reduce sciatic nerve pain. It may work by releasing natural pain relievers called endorphins.
For severe or persistent sciatica, prescription medications like gabapentin or pregabalin may be used under a doctor’s supervision.
Epidural Steroid Injections
Injecting corticosteroid medication around the irritated nerve roots helps decrease inflammation and pressure.
Spinal Decompression Therapy
Techniques like traction or inversion therapy take pressure off compressed nerves by stretching and realigning the spine.
Surgery like a microdiscectomy may be warranted in rare cases to remove a severely herniated disc pressing on the sciatic nerve.
Sciatica can cause severe pain that greatly impacts daily functioning and quality of life. While many turn to deep heating rubs for relief, current research on their efficacy is limited and conflicting.
Some studies suggest ingredients like capsaicin, menthol, and methyl salicylate may provide modest, temporary pain relief. However, the warming or cooling sensation is only a distraction and does not treat the root cause of the pain.
More high quality studies are needed looking specifically at using topical rubs to treat sciatic nerve pain. Deep heat rubs are unlikely to be very effective as the sole treatment for most cases of sciatica.
Deep heating rubs may provide minor relief as part of a more comprehensive treatment plan including stretching, anti-inflammatory medications, and postural correction. But they should not replace addressing the underlying spinal condition through conservative care or medical treatments.
In summary, deep heat rubs alone are likely not enough to manage most sciatica pain effectively. But some patients may experience modest short-term relief using them in combination with other evidence-based therapies.
1Derry S, Lloyd R, Moore RA, McQuay HJ. Topical capsaicin for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2009
2Black CD, Herring MP, Hurley DJ, O’Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. The Journal of Pain. 2010
3Higashi Y, Kiuchi T, Furuta K. Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: A randomized, double-blind, parallel-group, placebo-controlled, multicenter study. Clinical Therapeutics. 2010
4Green BG. Menthol modulates oral sensations of warmth and coldness. Physiology & Behavior. 2005
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6Higashi Y, Kiuchi T, Furuta K. Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: A randomized, double-blind, parallel-group, placebo-controlled, multicenter study. Clinical Therapeutics. 2010
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8Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2017
9Derry S, Moore RA. Topical capsaicin (low concentration) for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2012