ice or heat for back painBoth heat and cold can help reduce pain. So which should you use – ice or heat for back pain?

Back pain can be acute or chronic and in both cases, a cycle of pain has developed. There’s been some confusion as to whether ice or heat is best for pain. If you suffer from back pain, how do you decide which to use? The answer is that is depends on the cause of your back pain. The general rule is – heat for chronic back pain, cold for sudden back injury.

Ice or Heat for Back Pain? When to Use What…

Why Heat Is Best for Chronic Back Pain

Clinical studies show that heat is effective in relieving almost every type of lower back pain. Chronic back pain is usually deep in the back under a thick layer of muscle. Heat can penetrate deeply into the tissue and muscle whereas cold cannot get to the affected area. Back pain often involves muscular trigger points (muscle knots) that are helped by heat but aggravated by ice. Use heat on the affected area if you have:

  • chronic or recurrent back pain or
  • injury that is more than a day old.

How Heat Breaks the Pain-Spasm Cycle

  • When injury occurs, signals are sent to the muscles in the affected part of the body and they contract. Contraction is a means of protecting the area from further harm.

Heat soothes the nerves that fire the pain signals and so relaxes spasms and eases sore muscles.

  • When muscles are put under stress and deprived of oxygen, lactic acid is produced. Muscle contraction reduces blood and oxygen flow to the area, causing lactic acid to accumulate and the muscles become sore and ache.

Heat stimulates blood flow by widening the blood vessels and increasing blood supply, oxygen and nutrients to the area. Increased blood flow also gets rid of the lactic acid and the muscle pain eases.

  • Heat is soothing, comforting and reduces anxiety which has been shown to help reduce pain


Ways to Use Heat to Relive Back Pain

Heat should be applied to the area for 20 minutes, up to three times a day.

  • Apply a heat pad. Avoid falling asleep while the pad is on.
  • Take a hot bath or shower.
  • Use an all-day heat wrap. Studies have found that continuous low-level heat wrap therapy (CLHT) is more effective in reducing muscle and joint pain than oral analgesics and anti-inflammatory drugs.
  • Using a hot water bottle or warm compress.


Why Ice Is Best for Sudden Back Pain

Ice is used to treat minor back pain and lower back injuries and muscle strains. With new injury, the damaged tissue becomes inflamed and causes pain, swelling, or redness.

Ice is an effective method for reducing swelling and superficial inflammation that needs cooling. The majority of back pain is not traumatic in nature, there is no tissue damage or little or no inflammation which is why heat is more effective than ice for chronic back pain.

How to tell if you have acute back pain:

  • Did the pain come on suddenly while you were stretching or exercising?
  • Did you lift something very heavy or move awkwardly?
  • Is the muscle very sensitive to touch?
  • Is the skin hot, flushed, puffy and swollen?

If you answer ‘yes’ to these questions, you most likely have an acute back problem, so use ice.

How to Use Ice

  • Use an ice pack, a cold gel pack, a bag of frozen vegetables or a damp towel that has been sealed in plastic and placed in the freezer for about 15 minutes.
  • Apply cold immediately after injury or onset of pain.
  • Wrap ice packs in a towel before applying to an affected area.
  • Do not use ice if you have circulation problems.
  • Never use ice for more than 20 minutes at a time as excessive cold can cause tissue damage.

How Ice Works on Back Pain

  • It shuts down the nerves that fire the pain signals so numbing the pain.
  • It reduces inflammation as it cools the area.
  • It narrows blood vessels giving the muscles room to flex and become less inflamed.

Generally, ice is used for injuries and acute back pain, and heat is used for chronic back pain. Using ice or heat for back pain in the right situation can be an effective temporary measure but remember that they’re no substitute for medical evaluation and treatment.

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