Many people with a fresh back injury or chronic back pain lean on home remedies such as applying ice or heat – therapy that is inexpensive, easy and can offer quick comfort. But confusion swirls about which temperature is appropriate for which type of back pain, according to Kaixuan Liu, MD, PhD, founder and president of Atlantic Spine Center.
Known medically as cryotherapy and thermotherapy, respectively, ice and heat therapy can rapidly improve back pain or discomfort, Dr. Liu says. With 8 in 10 adults experiencing lower back pain at some point in their lives, using heat or ice has become be a go-to home remedy for many of these people.
“It helps, however, to understand when it’s best to pull out either the heating pad or the ice pack, and a lot of people don’t know the difference,” adds Dr. Liu, who is fellowship-trained in minimally invasive spine surgery. “While the risks are minimal either way, a few rules of thumb can straighten out any misunderstanding.”
When to use heat or ice therapy
Who should use ice? Ice therapy is best for fresh injuries to the back – such as a pulled muscle – or arthritis pain in the spine. “Cold calms inflammation that occurs as a natural response to injury and arthritis,” Dr. Liu says. “Tissues can become red, hot and swollen from both of these problems, and ice therapy is a mild way of dulling the pain from inflammation that doesn’t involve over-the-counter or prescription drugs.”
Who should use heat? Heat therapy is best for chronic pain, muscle spasms and pain from so-called “trigger points” – painfully sensitive spots. “Low back pain almost always benefits from applying heat,” he says.
What happens if you happen to use the wrong one? Nothing dramatic, so don’t worry, Dr. Liu says.
“Using heat when ice is warranted, or vice-versa, isn’t likely to cause great harm,” he explains. “Heat can make inflammation worse, and ice can worsen muscle spasms, so you might be uncomfortable longer if you mix them up. But the bottom line is that you should use whatever feels best to you, which is the most important factor.”
Tips for using heat or ice safely
Regardless of which type of temperature-related treatment you choose, doing it safely is key, Dr. Liu contends. He offers these tips to accomplish this:
When using ice:
- Apply ice 3 times a day for 10 to 15 minutes at a time.
- Always keep a damp cloth between your skin and the cold source, whether an ice pack, a bag of frozen vegetables, or frozen gel.
- Don’t apply ice for longer than 15 to 20 minutes at a time.
- Don’t fall asleep with ice on your skin.
When using heat:
- Moist heat (hot packs, baths or showers) tends to work better than dry heat.
- Try an all-day heat wrap, which is available for purchase in drugstores.
- If using an electric heating pad, don’t fall asleep with it on. Use heat pads set on low or medium, not on high.
Kaixuan Liu, MD, Ph.D., is a board-certified physician who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center in New York.
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