ICE Or HEAT For Back Pain?

Experts weigh in with the best remedies for back pain, including using ice and heat together

Exactly when, how, and for how long you should use ice or heat for lower back pain is a source of debate, and there aren’t always hard-and-fast rules. Back pain strikes up to 80 per cent of people at one point in their lives. Lower back pain can be short-lived – lasting four to 12 weeks – or chronic, in which it persists for 12 weeks or more.

There is a laundry list of potential causes of lower back pain: advancing age, underlying disease, overdoing it, a big or minor slip. And it can affect your vertebrae, joints, muscles, tendons, ligaments and discs. The cause of your lower back pain and the structures damaged both play a role in whether you’ll choose ice or heat during recovery.

COLD THERAPY

In general, apply cold to your back when the pain is acute, such as straight after an injury. This will help for the two days following your injury, according to the US Arthritis Foundation. Cold can also be helpful if your back aches after exercise.

“Lowering the body temperature will help constrict the blood vessels, reduce swelling, decrease inflammation, and cause a numbing effect,” says Dr Gbolahan Okubadejo, a spinal and orthopaedic surgeon.

You can use a ready-made ice pack or make your own. Apply cold for about 10 to 20 minutes a few times throughout the day. Be sure to protect your skin by wrapping the ice pack in a towel, don’t leave the pack on too long, and check your skin to make sure it’s not numb.

COLD, THEN HEAT

Sometimes, cold alone isn’t enough. In those cases, switch to heat once the inflammation has cooled, about two days later. “Use cold first and then apply heat for acute back pain,” says Dr Okubadejo. “Do this for 48 hours after injury to relax muscles and soothe painful areas.” The warmth stimulates blood circulation in your lower back, which in turn brings healing nutrients to the injured tissues, says Dr Okubadejo. He suggests using heat therapy intermittently for several hours or days to improve tissue healing.

Use a heating pad or a hot water bottle and mind the temperature to avoid burns. Apply heat in short bursts – no more than 20 to 30 minutes at a time.

HEAT THERAPY

When your back pain is chronic, heat therapy may be best. “Try continuous, low-level heat for chronic back pain,” Dr Okubadejo says. He suggests wrapping a heated blanket around your lower back. A heating pad is a good option for certain symptoms of back pain, such as the painful muscle spasms that can occur with some sprains and strains.

Muscle spasms cause your muscles to involuntarily tense up, says Dr Jordan D. Metzl, a sports medicine specialist. Heat can loosen up the muscles, he says.

WHEN TO SEE A DOCTOR

If your back pain persists, or gets worse, see a doctor to find out what is going on, Dr Metzl says. Your doctor can run tests to find the cause of your back pain and suggest additional treatments such as prescription or over-the-counter medications, steroid injections or physiotherapy.

Ice and heat aren’t usually meant to be stand-alone remedies for lower back pain, adds physiotherapist Dr Jake Magel. Other treatments may be needed to relieve your pain. “Generally, it’s an active approach with the goal of getting you back to your regular activities as soon as possible,” he says.