Heat or Cold - Which Is Better for Back Pain?

Most people experience back pain at some point in their lives.  It can be frustrating if your recovery feels slow or keeps you from your daily activities.  An ice pack may help with pain and swelling in the first couple of days if you feel muscle soreness or strain from a workout or injury.  After that, heat is a better option for pain relief and improved mobility.
​
While rest can be vital for your body to heal, sometimes even slight movements might help you regain strength and flexibility in your back.  Focus on minor, daily improvements, and do not get discouraged by setbacks.  Allow yourself to heal a day at a time.

Heat or Cold - Which Is Better for Back Pain?
By Pierre Mouchette | Bits-n-Pieces

​Back pain is widespread.  As many as 80% of people will experience it sometime in their lifetime.  For many, it will be 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 which kind of back pain you have?  This article will help you decide which is best for you when to put the hot compress and ice aside and see your health care provider.
 
When does ice help back pain? 
Ice can help with back pain in the first couple of days after a minor injury or strain.  For example, it can help if you have soreness after a challenging workout or feel like you tweaked a particular 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 flowing to those areas, swelling and inflammation also decrease.  But this also means that ice comes with some downsides:

• Some studies show that cold treatments can slow down healing over the long term.  This can increase the time it takes to recover fully.
• There is some evidence that cold can make muscles and ligaments less flexible.  It can mean a longer time to return to your normal activities.

And do not forget that ice can harm the skin if you leave it on too long.  To prevent any cold injury to the skin, only apply ice for 10 to 15 minutes at a time.
 
Types of cold therapy
Ice is not 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 the skin.  It can be more gentle than ice.
• Cold gel packs - you can buy these products in stores.  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).  Because the contents are smaller than ice cubes, they can easily mold to the injured area.
• Cold water immersion - in a home bathtub, sit in cold water at 54℉.  You may need to add ice cubes to lower the water temperature, especially during summer.
• Ice massage - in this approach, ice is massaged directly over the injured area of the 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 provide back pain relief in the right circumstances.  After the first few days of back pain, heat can help with ongoing pain and stiffness.  Studies show heat can benefit muscle soreness 1 to 2 days after a vigorous workout. 
Heat helps with pain by increasing blood flow. When you apply heat to a muscle, it relaxes and dilates the blood vessels in that area.  This increase in blood flow can help the body repair and heal the injured tissue. The warmth can also improve the elasticity of the site, which can help with flexibility and movement.
 
Types of heat therapy
There are several ways to apply heat to the back.  These can include:

• Hot water bottles - 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 are 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 - are convenient because you can plug them in without reheating.
• Heat wraps - these heat packs are attached to a bandage. It lets you strap the heat pack to the injured area, making it more comfortable.
• Saunas - are heated rooms that can help with larger areas of back pain or muscle soreness.

 
When to see a health care provider
Back pain usually improves with gentle movement and OTC pain medications such as ibuprofen (Advil) or naproxen (Aleve).
But there are a few symptoms you should not ignore because they may be a sign of something more serious than typical back pain.  You should see your provider right away if you have the following:

• Any leakage of stool or feeling like you can’t control your bowels
• Numbness in the groin and perineum (the area around the genitals)
• Pain that significantly limits your mobility
• Pain that’s worsening and does not improve with repositioning
• Shooting pain down your legs  
• Trouble urinating
• Weakness or numbness in one or both legs