When treating back pain, the appropriate use of ice and heat can make a big difference in how you feel and how you heal. Following these general rules will help you navigate the use of these healing modalities.
Ice or Heat for Back Pain
When dealing with musculoskeletal back pain, ice and heat can be very helpful. For over one hundred years, chiropractors and physical therapists have used cryotherapy and thermotherapy to help their patients feel better and heal faster. Yet, for many, there is still some confusion when to use ice versus heat. As a chiropractor, I have found that knowing their physiological effects can make it easier to understand when they are best used.
The physiological effects of cryotherapy (cold therapy) include reductions in pain, blood flow, swelling, inflammation, muscle spasm, and metabolic demand.
The physiological effects of thermotherapy (heat therapy) include pain relief, reduction in muscle tension and spasm, and increases in blood flow, metabolism, and elasticity of connective tissues. Heat therapy can also reduce pain from delayed-onset muscle soreness (DOMS).
Ice for Back Pain
Most chiropractors will usually recommended ice for the first 48-72 hours following acute musculoskeletal injury (e.g. sprains, strains). It is best used immediately following the injury. There is little evidence to support its use after 72 hours.
Use Ice to:
Decrease inflammation
Decrease swelling
Decrease pain
When using ice, only apply for a maximum 15 - 20 minutes every 2 to 3 hours. In addition, to prevent frostbite, use a thin cloth or thick paper towel between the ice and skin.
Heat for Back Pain.
Heat can be applied anytime ice is not indicated for use.
Use Heat to:
Decrease pain
Decrease muscle soreness
Decrease muscle spasm/tightness
Relax the body (soothing effect)
Using a towel between the body and heating source, heat therapy can be applied for 15 minutes up to 2 hours. To avoid burning, pay close attention to the heat. It should never be painful or uncomfortable.
When using either ice or heat, you should notice some minor reduction of pain, within a few minutes. If the pain does not improve or gets worse, you may need additional help.
Back pain can be caused by a lot of different health conditions. It is important to know the underlying cause of your pain. If you are uncertain of why you are having back pain, the pain is severe, or it is accompanied by any other symptoms, visit your chiropractor or urgent care center, as soon as possible.
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