Should You Use Ice or Heat for Back Pain

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Back pain is very common. As many as 8 in 10 people will experience it at some point in their lifetime. For many, back pain is debilitating at first. But most of the time, home remedies and over-the-counter (OTC) treatments can help ease the pain and get you back to your regular activities.

Home remedies can be as simple as heat or ice. But which one is more effective? And does it matter what kind of back pain you have? We'll discuss how to decide which one is best for you and when it's time to put the hot compress and ice aside and get professional help.

Back pain: Cold vs. heat

The short answer:Start with ice when your back hurts after a minor injury. Cold therapy is most helpful right after you experience pain and up to the first 2 days.

Afterward, heat will likely give you more pain relief. Plus, heat helps with stiffness and loosens up your muscles and joints. This will help with your mobility and get you back to your normal activities.

The long answer: The scientific research on ice versus heat for back and muscle pain is mixed. In one study looking at muscle soreness (not specific to back pain) after strenuous exercise, cold therapy helped more with pain relief right after exercise and for up to 48 hours. So, if you overdid it or tweaked your back, especially if it was right after a workout, ice may help.

But when the pain shows up later, heat might be a better choice. A review of research studies looking at delayed muscle soreness shows that heat packs were more effective than ice.

For pain lasting longer than a few days, research gives heat a slight edge. One review study looked at all the available data in regards to heat versus cold for back pain. It found there was some evidence that heat provided a small amount of back pain relief, while ice was not as helpful.

A second review study showed that heat therapy not only helped somewhat with pain but also helped people move more easily. By improving their ability to move, heat helped people to return to their normal levels of activity quicker.

In all the studies, there was no evidence of significant harm from using either heat or cold therapy. So, both are generally safe.

Let's take a closer look at when to use ice and when to use heat.

When does ice help back pain?

Ice can help with back pain in the first couple of days right after a minor injury or strain. For example, it can help if you have muscle soreness after a particularly hard workout or if you feel like you tweaked a certain spot or pulled a muscle.

When you apply ice to an area of your body, nearby blood vessels constrict and decrease blood flow to that area. With less blood flow, swelling and inflammation in that area also decrease.

But there are also some possible downsides to ice:

• Slower healing: Some studies show that cold treatments can slow down healing over the long term. This can increase the time it takes to recover fully.

• Reduced flexibility: There's some evidence that cold can make muscles and ligaments less flexible. This can mean a longer time for you to get back to your normal activities.

• Skin injury: Ice can harm your skin if left on for too long. To avoid any cold injury to your skin, wrap your ice pack in a towel and apply it for only 10-15 minutes at a time. Be extra careful when using ice if you have a circulatory or nerve problem from conditions like diabetes or neuropathy.

Types of cold therapy

Ice isn't the only way to do cold therapy. There are several other ways to apply cold to an injured back:

• Cold towels: Immerse towels in an ice bath, then apply the towel to your skin. This can be gentler than using ice directly.

• Cold gel packs: You can buy these in stores, and many people prefer them because they keep things dry.

• Ice packs: You can use a plastic bag filled with ice. Or you can try a bag of frozen vegetables (like peas or corn). Since the frozen pieces are smaller than ice cubes, they can easily mold to the injured area.

• Cold water immersion or ice baths: For this, sit in cold water at a temperature of 54℉. Athletes may have access to cold pools, but you can take an ice bath in a home bathtub. But being fully immersed in cold water can affect your heart rate and blood pressure. If you have a condition like high blood pressure or heart disease, talk with a healthcare professional before trying this.

• Ice massage: In this approach, ice is massaged directly over the injured area of your back. But ice massage is less effective at alleviating pain when compared to cold water immersion.

When does heat help back pain?

Heat can also relieve back pain in the right circumstances. After the first few days of back pain, heat can help with ongoing pain and stiffness. Studies show that heat can be especially helpful for muscle soreness 1 to 2 days after a vigorous workout.

Heat helps pain by increasing blood flow. When you apply heat to a muscle, it relaxes and dilates the blood vessels in that area. This increased blood flow can help your body repair and heal injured tissues. The warmth can also improve the elasticity of the area, which can help with flexibility and movement.

Similar to ice therapy, there can be some downsides to heat therapy. Heat can burn your skin if it's too hot or you apply it for too long. Be extra careful if you have a condition that affects your nerves.

Types of heat therapy

There are several ways to apply heat to your back. These can include:

• Hot water bottles: These are usually plastic or rubber bags (sometimes with a soft cover) that you fill with hot water and then place on the area that hurts.

• Heat packs: You can buy these in stores. They're filled with different substances that you can warm in the microwave.

• Hot towels: You can make these by dipping towels in hot water or microwaving wet towels.

• Heat pads: These are convenient because you can plug them in without the need to reheat.

• Heat wraps: These heat packs are attached to a bandage. This lets you strap the heat pack to your injured area, which can make it more comfortable to wear.

• Saunas:Saunas are heated rooms that can help with larger areas of back pain or muscle soreness. If you're pregnant, talk with your OB-GYN before using full-body heat therapy like a sauna.

• Hot baths: A hot bath is another way to target larger areas of your back and body.

When to see a healthcare professional

Most of the time, back pain will get better over time with gentle movement and OTC pain medications such as ibuprofen (Advil) or naproxen (Aleve).

But there are some symptoms you shouldn't ignore, as they may be a sign of something more serious than typical back pain. Get medical attention right away if you have:

• Weakness or numbness in one or both legs

• Shooting pain down your legs

• Trouble urinating

• Any leakage of stool or feeling like you can't control your bowels

• Numbness in the groin and perineum (the area around your genitals)

• Pain that's worsening and doesn't improve with repositioning

• Pain that significantly limits your mobility

Frequently asked questions

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