Is ICE or HEAT better for my severe back pain?

Great Question!

The answer to this question depends on the stage of healing that your body is going through. In the acute stage of healing, when inflammation is setting in (usually at the time of onset to 72 hours), it is best to use ice on the injured site due to the inflammation. The ice will help to reduce the inflammation and also aids in masking the pain from the injured site.  If your pain is constantly being exacerbated or irritated by certain movements or activities, this resets that 72 hour time frame and ice should be reapplied during this time.  Ice treatment may be applied for 20 minutes at a time with one hour between applications.  Always make sure to have a cloth between the ice pack and your skin.

Most of the patients that initially seek treatment in my office tell me that they have been using heat to reduce the pain and inflammation. This actually acts against the idea of reducing inflammation. The heat will bring more blood and body fluids to the site causing the inflammation to become worse. You have to be careful at this stage of healing because if the inflammation gets really bad there is a possibility of additional damage to the area. The cryotherapy (ice therapy) will help to reduce the inflammation.  As our providers often say “When in doubt, use ice!”

The next part of the question is about heat. While heat seems to “feel good” at first, it is best to leave the heat until after the inflammatory stage of healing. After the inflammation has subsided the heat will aid in healing since it attracts blood and healing enzymes to the injured site.  Many patients inappropriately apply heat, only to notice that their symptoms worsen or do not improve.  Because they typically wouldn’t notice a worsening of their symptoms for hours or even a day or two after applying heat, patients may not relate the worsening of their symptoms to the heat.  If you have been applying heat and your symptoms have not been improving, try switching to ice.

I hope I was able to help answer your question and I look forward to answering more questions in our next blog post.