a few months ago

Is It Best To Use Ice Or Heat To Treat Your Lower Back Pain?

Ice or heat for lower back pain

I'm sure we've all experienced using some form of ice or heat to take the edge off our back pain before. 

Whether that is simply having a nice hot bath or ​laying down on a pack of frozen peas, the relief that follows is a great feeling. 

And these are both cheap and easy options for you to self-treat your back pain.​ 

However it can be confusing to know which method works best. 

​And it can be easy to fall into the trap of thinking it's simply a case of personal preference as to which one is best for you to use. 

But this is not the case. 

Because while using ice or heat can help your back pain. 

Using either one for the wrong type of back pain can cause you even more pain and discomfort. ​

​For instance, did you know that using ice at the wrong times can actually increase muscle stiffness and tightness? 

While using heat at the wrong times can make inflammation worse and leave you in even more pain?

No?​

Well read on to discover just when to use ice and heat and make sure you are treating your back pain in the correct way.​

When Should You Use Ice To Treat Back Pain?

It was the straw coloured box that broke the camel smoker's back.

Ice is great for treating newly acquired back injuries.

So if you put your back out lifting something heavy, suffer whiplash from an accident, or rip or tear a muscle in your back, icing it is your best bet.​

This is because the ice reduces the inflammation and swelling ​that occurs in new injuries, speeding up the healing process.

​And this will also dull the pain you feel in your back, while reducing any tissue damage.

So great news all round.​

However you need to be aware that this is only the case for fresh injuries and those that have inflammation.

Because icing chronic and recurring back injuries that have no inflammation can actually cause you more damage.

It can increase feelings of muscle tightness and stiffness and make your back pain worse!

​And as inflammation is rarely a cause of chronic lower back pain, you need to ensure that you only use ice when you feel you have actually injured your back due to a specific event.

This can be hard to do at times, because even recurring back pain can feel like a fresh back ​strain (and swelling is hard to spot).

However before reaching for the peas, ask yourself the following:​

  • Did the pain strike you suddenly as the result of something you did?
  • Is the area sensitive to touch and swelling up?
  • Does your skin feel hot and look red and flushed?

If you can answer yes to one or more of these then icing your injury should be the way to go.

However if you are having a flare up of back pain that has no specific origins then be wary, as this could be due to muscle knots, cramps or spasms instead.

And these problems should be treated with heat rather than ice.​

The Benefits Of Using Ice To Treat Back Pain

Outdoor swimming is a popular summertime activity amongst the natives in Scotland.

Don't worry, you don't need to go to the extremes of the guy above to feel the benefits of using ice for your back pain.

But using ice can really help you after an injury.

Because when you injure your back your body suffers trauma, and as a result the area gets inflamed and swollen.

And this inflammation can be extremely painful, as well as delaying the healing process.

However by using ice in the first couple of days after the injury you can:​

  • Minimise this inflammation and swelling.
  • Reduce any damage to your tissues in the pain area.
  • Numb any sore tissues, reducing the pain and discomfort you feel.
  • Get a natural form of pain relief rather than using anti-inflammatory medicine which can come with side-effects.
  • Help your body to heal faster.

How To Use Ice To Treat Back Pain

Once you are sure you are treating a fresh injury rather than chronic muscle pain, you are ready to grab the ice!

This can take many forms such as gel packs, ice packs, frozen towels and even the old favourite - a bag of frozen peas.​

But whatever you decide to use, make sure you are following these guidelines when using ice for your back pain:​

  • Make sure that you place a cloth between your skin and the source of ice to avoid getting 'ice burn'.
  • Don't apply the ice for more than 20 minutes at a time.
  • Don't exceed 8-10 applications per 24 hours.
  • Only use ice for the first 24-72 hours after you sustain your fresh injury.

After this 72 hour period your inflammation should have gone down enough to move on to the next stage of the healing process.

And this is when you should switch to treating your pain with heat instead.

When Should You Use Heat To Treat Back Pain?

Pain relief cream

Heat therapy is great for relaxing your body and mind, taking the edge off persistent and recurring back pain.

This includes things like muscle knots, cramps, overuse injuries, and general aches and pains.​

And the vast majority ​of back pain people experience comes from these problems rather than inflammation.

Making using heat a great choice for those of us with chronic lower back pain.

In fact it can become an important part of your regular pain management routine​.

So how does heat therapy help you?

Firstly, the heat stimulates blood flow within the affected area (in our case the lower back).

And this increased blood flow ensures that the damaged tissues and muscles get the oxygen and nutrients they need to be able to heal.

Secondly, the sensation of heat on the skin's sensory receptors ​irritates them to the point where this irritation takes priority over the feelings of pain in the area.

This blocks pain signals from reaching your brain, reducing the amount of pain you feel.

​Finally, using heat therapy helps you to relax.

This is great for you physically as it reduces the amount of tension and stiffness you feel in your muscles.

Leaving you feeling more flexible, comfortable and happier in your body.

But it is also great for you mentally, and this is so important.

Because ​problems such as anxiety, stress and tension are all very common amongst people with chronic pain.

And they all only serve to make your pain worse.

So by finding ways to relax you are actively reducing your levels of stress and anxiety.

And using heat will help you to do this, reducing the amount of pain you feel.​

When You Shouldn't Use Heat To Treat Back Pain

While using heat is great for chronic pain, it can be harmful when used on fresh injuries.

This is because using heat on an injury that has inflammation or swelling will only make the inflammation worse.

And this increases the pain you are in and delays the recovery process.

​So for fresh injuries make sure you are using ice instead for the first couple of days.

And only once the inflammation has subsided can you then switch to heat to encourage your back to heal.

​Also, heat therapy may not be good for you if you suffer from any of the following:

  • Certain skin conditions such as dermatitis.
  • Diabetes.
  • Deep vein thrombosis.
  • Heat sensitivity.
  • If you have any open wounds or cuts.

The Benefits Of Using Heat To Treat Back Pain

People with chronic and recurring back pain can really benefit from using heat therapy.

This is because it is great for pain caused by muscle knots and cramps.

Which is good news as this is where most unspecified chronic back pain comes from.​

In fact using heat is a great option for any muscle pain ​that doesn't involve inflammation and swelling.

  • It can help your back heal from injury after the initial swelling and inflammation has gone down.
  • It helps to deliver oxygen and nutrients to the damaged muscles and tissues by increasing blood flow to the area.
  • It helps to block pain signals to the brain.
  • It helps you to relax in both body and mind.
  • It reduces stiffness and increases your flexibility.
  • It can reduce stress, anxiety and tension.
  • It causes the release of endorphins within your body, which work as a natural painkiller.
  • It is a cheap form of treatment that is easy to apply.
  • It doesn't carry any side effects, unlike taking pain medication.

How To Use Heat To Treat Back Pain

Not all heroes wear capes.

The aim of using heat therapy to treat back pain is to get the heat to penetrate deep enough to reach the damaged muscles and tissues.

It's no good just warming the skin, you need the heat to really get in there to have an effect.

There are many ways to do this, which I'll go over in a moment, and they fall into two categories.

The first way is the application of dry heat in the form of things like electric heating pads and heat wraps.

These can work well but don't penetrate very deep, and can leave your skin feeling dehydrated.

The second is by applying moist heat, such as taking a hot bath​, which allows greater penetration of the heat into the damaged muscles.

But the aim with all of them ​is the same.

You need to maintain a steady, warm temperature in your pain area for a certain length of time.

The length of time you need to maintain this heat for depends on the severity of your pain.

So for minor pain look at maintaining a warm heat to the affected area for between 15-20 minutes.

And for severe pain you can increase this to between 30-120 minutes.​

Now let's go through the different ways you can ​apply heat to your back.

​Electric Heating Pads

Electric heating pads are a good way of applying steady and consistent heat to the whole of your back area.

To use one you plug it in, lay down flat on your stomach, ​drape it over your back and let the heat penetrate down into you.

It's a bit like a sunbathing sensation, and it's quite easy to imagine yourself laying on your favourite beach (minus the sounds of the waves crashing against the shore!).​

These pads are popular for home use, and can be effective in relaxing stiff and sore muscles.

However they do come with some issues.

Due to safety concerns you usually need to manually hold a switch down to keep the heat on, which can be a bit annoying after a while.

Also laying down on your stomach can be an uncomfortable position for some people with back pain (it is for me).

And the dry heat that is generated doesn't tend to penetrate as deep as some other forms of heat therapy.

However having said all that, plenty of people with chronic back pain swear by them.

So if you'd like to try one out I'd recommend the Thermophore Heating Pad.

This one is bigger than most so will cover your entire back area, as well as the top of your legs.

And it provides a moist heat rather than a dry one, and as a result penetrates deeper.​

And if you do decide to try an electric heating pad such as this one, just keep the following in mind:​

  • Don't lay down or rest on the heating pad as it could cause your skin to burn.
  • Keep an eye on your skin and make sure it isn't becoming irritated by the heat.
  • And if you find one that stays on without having to hold a switch down, make sure you DON'T FALL ASLEEP!!

Far Infrared Heating Pads

A better (although more expensive) option to electric heating pads are far infrared heating pads and mats.

​Unlike getting heat from the electric, these pads deliver heat through far infrared light rays instead.

These rays are created from natural jade stone and carbon fibres which are woven into the pads.

And the rays turn light energy into heat energy in the body, and as such can penetrate much deeper into the pain area.

​This will give you a soothing and relaxing deep warmth that will help your muscles to fully relax and heal.

​And they are safer than electric heating pads too.

As they don't emit high levels of electromagnetic radiation and won't burn or dehydrate your skin.

In fact you can lie on them or even wrap them around your body without fear of harm.​

And don't be fooled by the term infrared.

As these rays are not the same as UV rays and won't put you under any danger ​of skin cancer or damage.

So they are a great option for using as heat therapy for your back.

However some of them can be very expensive and out of most people's price range.

But if you do fancy trying one, a good option at a reasonable price is the UTK Infrared Healing Pad.​

This one comes in a medium size and you can either lay down on it with your lower back, or wrap it around yourself as you sit in a chair.

​Give it a go and see what you think.

Microwaveable Gel Packs

​Reusable gel packs are a cheap and easy solution that give you the best of both worlds.

This is because you can use them for both icing and heating your back pain.

Just put the gel pack in the freezer for two hours and you have an ice pack that will hold it's temperature for around 20 minutes.

Great for any fresh injuries.​

And if you need heat instead, pop it in the microwave for 30-60 seconds (read the guidelines!) and you have a hot pack to help your muscles to relax​.

A good one to try for back pain is the TheraPAQ Gel Pack.​

This one comes with a velcro waist strap so you can wear it against your lower back while on the move, rather than laying down.

Just be careful when using these gel packs, as they can be dangerous if you don't follow the instructions.

For instance the gel can get incredibly hot, so make sure you don't overheat them or you risk burning yourself.

Also when overheated they can expand and explode.

So read the instructions!

But if you're careful they can be a great option to have around the house (and to keep in the freezer for emergencies!).​

Heat Wraps

Heat wraps are a good temporary fix when you have back pain when on the move.

This makes them a great option for helping you to get through the work day on site, or if you have to spend a long time behind the wheel.​

And while they won't penetrate that deeply, they can still give you some relief and comfort when your back is giving you gip.​

The wraps I'd recommend going for are the Thermacare​ Heat Wraps.

These are good quality, fit nicely under your clothing and can help your muscles stay warm and relaxed during the day.

Infrared Heat Lamps

​Infrared heat lamps are another way to get the benefits of far infrared light for your back pain.

When you shine the infrared light from the lamp onto your pain area​ it penetrates deep into your body.

And when this infrared light turns into heat deep within your pain area, it helps to increase circulation to it.

Which increases the flow of oxygen and nutrients to your sore and aching muscles.

Helping the healing process and leaving you feeling relaxed and in less pain.​

The idea is to position the lamp about 12 inches away from you and facing your pain area as you sit​ or lie down.

Then you just relax and let the rays do their work for between 5-30 minutes.

So if this form of heat therapy sounds good to you, one lamp I'd recommend trying is the ​Beurer Infrared Heat Lamp.

This one is powerful enough to really penetrate into your painful muscles.

And the tilting handles make it easy to adjust to the perfect angle and position.

Just be careful when using these lamps, as they can get extremely hot.

So don't use them for too long, and don't get too close!​

A Hot Bath

This guy doesn't give a rubber duck about his back pain.

This one's my favourite form of heat therapy.

After all, is there anything better than soaking in a hot bath when your muscles are tired and aching after a hard days​ graft?

​Not only does it totally relax you.

It can also really loosen up those aching muscles​, and go a long way into reducing muscle spasms, cramps and pain.

So put some tunes on, get the rubber duck out and enjoy!

Just remember not to make it scoldingly hot. Warm heat rather than lobster red is the aim here.

Going To A Sauna

"Another ladel on the coals Ingrid?"

Aside from having some incredibly beautiful women, the Swedes have also been onto something good with saunas.

Because not only are they great for:

  • Flushing out toxins.
  • Cleansing your skin.
  • Increasing circulation.
  • Relaxing you.
  • Improving the movement of your joints (great for people with arthritis).

The heat you are exposed to in them also works wonders for ​relaxing your sore muscles and easing your back pain.

Plus they leave you feeling fantastic afterwards too.

Now not everyone will have access to a sauna.

But if you do have an option of using one it is definitely something to consider.

Or if you are a plumber (and have a bit more disposable income than the rest of us!) maybe you could install one in your backyard.

How great would that be to come home to? (even if it is without the Swedish women).

'Deep Heat' Style Pain Creams

Now when you first started reading about using heat on your back pain, you may have been thinking about 'hot' pain creams such as Deep Heat.

However while these creams give the sensation of heat, they are actually spicy rather than hot.

They work by irritating the skin's nerve sensors in the pain area.

Which helps to block pain signals from reaching the brain, and leads to a reduced sensation of pain.

So while using one of these creams is not strictly using heat therapy, it can provide similar effects.

And one I'd recommend you use for this purpose is Capzasin-HP Topical Analgesic Cream

This one is strong enough to pack a real punch, and comes without the overpowering smell that some of the others on the market have.

Just beware that the strong, burning sensation this gives you will not be suitable for everyone.​

Rounding Up

So I hope that after reading through this article you are now more clear on when you should and shouldn't be using ice and heat for your back pain.

It's not a case of which is better, it is about using the right one to treat the right kind of back pain at the right times.

So for fresh injuries and back pain that involves inflammation and swelling, you need to be using ice to bring this inflammation down.

You can do this by applying ice packs directly to the pain area (just remember to use a cloth between the ice and your skin).

However for chronic and recurring back pain such as muscle knots, cramps, and sore and aching muscles, heat is the way to go.

This will help your muscles to relax, increase your blood flow so they get the oxygen and nutrients they need to heal, and block pain signals from reaching the brain.

Which will leave you feeling relaxed, comfortable and in less pain.​

So make heat therapy a regular part of your pain management routine, and limit the icing to the times when you have suffered a new injury.

Let me know if this helps and how you get on with the recommendations in the comments below.​

Resources used in researching this article:

https://www.spine-health.com/blog/should-i-use-ice-or-heat-my-lower-back-pain​

https://www.painscience.com/articles/ice-heat-confusion.php​

https://www.painscience.com/articles/icing-exceptions.php​

https://www.painscience.com/articles/heating.php

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Daniel

A 30-something painter and decorator, psychology graduate, and veteran of 5 spinal surgeries. Looking to explore the physical, psychological and emotional effects of living with chronic low back pain.

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