Should You Use Ice or Heat for Your Back Pain?
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links."
Most people experience some back pain at some point in their lives. For others, the discomfort is a chronic, aching condition. However, when it comes to finding relief, some will suggest using ice and some will suggest using heat—but how can two opposite sensations both help ease your suffering? So, if you’re wondering if ice or heat for back pain is more effective, you’re not alone.
Meet the Experts: Bestin Kuriakose, D.O., specialist in interventional spine and pain management with New York Spine Institute; Rahul Shah, M.D., board-certified orthopedic spine surgeon with Premier Orthopaedic Spine Associates.
Turns out, both cold and heat therapies have their time and place for treating your back pain. But how can you know which is right for your kind of ache? Here, experts explain when to use ice, when to use heat, and when to see a doctor about your back pain if all else fails.
Cold vs. heat for pain
With regards to the modalities of heat and cold, each works to modify the blood flow to the muscles and joints in the area applied, says Rahul Shah, M.D., board-certified orthopedic spine surgeon with Premier Orthopaedic Spine Associates. “With regards to the spinal area, heat will serve to increase the local blood flow, and this can help sore muscles later in the phases of fatigue related and arthritic pains. Cold is usually used to help those with more immediate irritations to the back such as those caused by turning the wrong way,” he explains.
While these are general guidelines, it is important to keep in mind that different contexts for discomfort are not always immediately apparent, Dr. Shah points out. Therefore, a good rule of thumb is to pick either cold or heat and trial for 20 minutes to see how one responds, he advises. “If there is not significant improvement, try the alternative to see if there is improvement.”
Additionally, it’s critical to examine the skin to ensure there are no cuts or abrasions, Dr. Shah adds. “You should also inspect the skin to ensure there is no excessive reddening as this could become the precursor to a burn from application of heat or cold,” he notes.
When to use ice for back pain
Cold therapies work for pain by decreasing the acute inflammatory response, says Bestin Kuriakose, D.O., specialist in interventional spine and pain management with New York Spine Institute. “Cold leads to localized constriction of blood vessels, decreases muscle spasms and decreases metabolic demand.”
Ice can be used for back discomfort when there is a clear injury or irritation after moving in a suboptimal way that generates pain, says Dr. Shah. “However, other cold alternatives can also be used such as a cold towel or frozen peas or corn (as these won’t melt),” he suggests.
Dr. Kuriakose adds that ice should be used in the setting of an acute injury, which is typically less than 3 months. “If you notice you hurt your back after a recent physical activity, ice can help decrease the acute inflammatory response and swelling,” he explains.
Types of cold therapy
To try using ice, or cold, for your pain, here are some types of cold therapy that Dr. Kuriakose recommends:
Cold packs
Ice massage
When to use heat for back pain
Heat therapies work for subacute pain and/or chronic conditions, says Dr. Kuriakose. “Heat can help reduce pain thresholds, reduce muscle spasms, help with chronic inflammation and decrease stiffness in joints.”
A common finding with chronic back pain is facet joint arthritis in the spine which can lead to stiffness and pain, Dr. Kuriakose continues. “Facet joints are small joints seen in the spine and they can develop arthritis.” Appropriate use of a heating modality can help reduce the stiffness and associated pain, he notes.
Heat can generally be used for back discomfort that is consistent with a chronically aching back and those that have arthritic back pain, adds Dr. Shah. “It is however important to inspect the skin as burns have been noted to occur after overexposure to heat.” This can include modalities such as a moist towel that is microwaved for 20 seconds, a prepackaged sand pack that is also microwaved, to an electric blanket, he suggests.
Types of heat therapy
To try warming up your achy back, here are some types of heat therapy that Dr. Kuriakose recommends:
Hot packs
Hydrotherapy, such as running a hot bath
Ultrasound therapy, which uses high-pitched sound waves to create heat and vibrations in the body to treat pain, inflammation, and other conditions
When to see a doctor for back pain
Back pain that lasts more than a few weeks should be investigated and discussed with your doctor, says Dr. Shah. “Other signs that occur alongside back pain require more urgent evaluation,” meaning you should head to the ER. Such signs include:
Fevers
Feeling weak or unbalanced
Significant unintended weight loss
Pain going down into the legs
Every individual presents in a unique way, says Dr. Kuriakose. “There are many different causes of back pain. Being evaluated early by a doctor with a good history and physical exam can help get the appropriate diagnostic imaging and treatment plan in place,” he advises.
You Might Also Like
