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Is Ice or Heat Better for Back Pain?

November 14, 2021
By Mark Wang, MD

Back pain is a prevalent experience for most people at some point in their adult lives. Applying heat or ice is one of the tried-and-true methods of at-home treatment for back pain, but how do you know which method to use and when? Get to know how to use ice or heat for back pain and when to use both.

When to Use Cold Therapy for Back Pain

Deciding between heat or ice for back pain can be tricky. The best place to start is by considering the pain’s source and what is causing the discomfort. The following conditions can benefit from cold therapy.

  • Acute back injury: Ice for back pain can be an effective pain reliever if you are experiencing an acute injury. For example, maybe you strained the muscles of your lower back by lifting something too heavy. The cold from the ice can help to reduce inflammation in the affected area. If you want to address an acute injury, it’s best to apply cold therapy within two days of the injury. 
  • Soreness from exercise: Exercise can help alleviate and even prevent recurrent back pain. Depending on the types of exercise you are doing and the intensity, you might feel sore after a workout. The cold can help ease the strain and tension in your muscles. 
  • Sciatica: Sciatica is the name for pain in the sciatic nerve, which begins in the lower back and travels down through the buttocks and the legs. If you are having a sciatica flare-up, immediate application of cold therapy can help to reduce the pain and inflammation. Cold therapy may also help reduce the muscle spasms associated with sciatica. 

How to Apply Ice

There are several different methods for icing your lower back. For instance, you can perform ice massage therapy, which entails gently rubbing a chunk of ice over the affected area to help numb your back and reduce any pain. You can also apply ice without any massage if you have a store-bought or makeshift cold compress, such as a bag of frozen vegetables. 

If you use ice for back pain, remember not to leave any ice directly on your skin for a prolonged period to avoid potential burning. If you plan to leave the cold compress in place, wrap the ice pack in a thin washcloth or a couple of paper towels to create a layer of protection between the ice and your skin. You can ice for up to 20 minutes at a time

When to Use Heat Therapy for Back Pain

Is heat good for back pain? The answer depends on what type of back pain you are trying to address. If you are living with chronic pain or discomfort that lasts for more than four weeks, heat may help relax the tissues in the area and decrease pain signals. Heat can also encourage blood vessels in your back to dilate, which can promote healing.

How to Apply Heat

Like cold therapy, heat therapy is a versatile treatment that lends itself to several options.

  • An electric heating pad: Heating pads plug into the wall and provide a consistent heat source to help ease your back pain. Many heating pads allow you to control the temperature and set a timer, ensuring you do not leave the heat on your back for too long. 
  • A hot water bottle: Hot water bottles can provide heat. Remember to wrap a light washcloth around the surface if it is too hot to touch with your bare hands. 
  • A bath: A hot bath can help to ease your back pain and any other muscle soreness you may be experiencing. 
  • Adhesive heat wraps: Wear over-the-counter adhesive heat wraps underneath your clothing for a safe, low-level amount of heat lasting several hours. 

If you use heat for lower back pain, it is vital to protect your skin. Make sure whatever heat source you use is warm rather than hot, and do not leave it on your body for too long. 

When to Use Heat and Ice Therapy for Back Pain

If you are debating between heat or cold for back pain, sometimes the answer is both. If you are planning to exercise, you can use a combination of heat and ice therapy to help manage any potential back pain.

Before starting your workout, use a warm compress to help relax the muscles in your back and prepare them for movement. Approximately 10 to 15 minutes of heat therapy is usually adequate.

After you cool down and stretch, use some cold therapy to help soothe any soreness in your muscles. You can apply the ice pack or cold compress immediately after working out or later in your day.

Tips When Using Heat and Ice Therapy

If you plan to regularly use heat and ice therapy, it can be helpful to have both options on hand. If you work out first thing in the morning, you can keep an electric heating pad plugged in by your bed. Wake up, get some heat on your back muscles, then dive into your workout routine. It can be helpful to keep a few different cool packs in the freezer so they will be ready for use whenever you need them. Cold showers and hot baths can also be a beneficial way of augmenting your go-to cold and heat therapies. 

Whether you are doing individual cold or heat therapy or a combination of both, always remember to protect your skin. Set a timer for your therapy sessions to ensure you do not leave the ice or heat on your back for too long. 

Schedule an Appointment

You can treat occasional back pain at home with heat and cold therapy, but chronic back pain or recurrent issues mean it is time to go to a doctor. At DISC, our team diagnoses and provides care for a wide range of conditions that cause back pain. 

Pain severely affects your quality of life. Instead of ignoring your back pain, you can proactively find the root cause and start treatment to reduce your pain and reclaim your life. Schedule an appointment online to get started. 

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