When to use Ice or Heat for Back Pain

Many patients ask this very question about back pain and how they can help themselves. They don’t know when they should use ice or heat. The information on the webs can be confusing as well with regards to ice or heat for injuries. Let’s help you out with which one, you should be using.

The older outdated protocols for a recent (acute) injury used to suggest that we use ice first in many situations. However, as more research is done into injury care we now know that it is better to use the acronym PEACE with a recent injury.

P-protection

E- elevations

A- Avoid anti-inflammatories

C- Compression

E – education

So for any new injury you want to protect the area which means in the case of your back you want to avoid doing the activities which increase your pain such as lifting.

Elevation in this case would refer to your legs which takes the pressure off the back.

Avoid anti-inflammatories as it is felt that the inflammatory response is important for any injury to heal.

You can compress the area by using a soft brace to give you extra support. You can also use kiniesiology tape for support as well although it does not provide compression.

Education is important because it helps you to understand the nature of the injury and why it has happened and what are the things you can do to change your back pain.

So new protocols do not suggest the use of ice but instead recommend you avoid them. However, clinically I have found that ice used in a limited way helps to relieve the muscle spasm which occurs in some back pain patients. When your back is trying to protect you from further injury it may spasm to limit your ability to move and create further damage.

Muscle spasms themselves can be more painful than the actual injury your back is trying to avoid. In this case an injury is not present so Ice can be used in this case. This is exemplified by the back going into spasms but no presence of swelling associated with injury.

So there you have it …… use cold when you are having a spasm.

The ideal time to use heat is in a chronic or long term injury when the muscles may feel achy and stiff. The warmth helps to increase blood supply to the area and relaxes and soothes the tissues. An increase in blood supply will also mean an increase in oxygenation to the area which will assist in the healing process.

That is why a nice warm shower would feel good in the morning when you get up and the muscles are cold and stiff from sleeping all night. Add some Pilates movements to that and it should feel just great!

So heat is the way to go when the injury has been around for a while and there is a nagging pain.

My warning to you though is that each person is an individual so if you try one or the other and it doesn’t make you feel better then discard it as a tool to assist with your pain management and get an assessment of your issue from a Physiotherapist who deals with back pain on a daily basis. That healthcare professional is therefore a specialist and can give you the correct treatment for your back.

As always check out our back pain ebook for more tips to help you with your back pain.