Fire and Ice
“Some say the world will end in fire,
Some say in ice.
From what I’ve tasted of desire
I hold with those who favor fire.
But if it had to perish twice,
I think I know enough of hate
To say that for destruction ice
Is also great
And would suffice.”
Still confused? You should be, for this is an absolutely esoteric, willy-nilly response to the question of using ice or heat to relieve back pain. Hopefully, the remaining entry will clarify some of the basics when utilizing ice or heat for pain relief.
Let’s start with ICE:
Ice should ALWAYS be used after an acute injury or trauma to the back (or any other area of the body.)
Why ice immediately? Ice is a potent vasoconstrictor: cold causes the muscles of the body, especially those lining the walls of our blood vessels, to constrict decreasing the swelling and pain associated with the body’s inflammatory response. As the vessels constrict, fewer inflammatory mediators (chemicals released in response to injury,) seep into the area. In the case of musculoskeletal injuries, decreasing the inflammatory response decreases pain and prevents a hyper-immune response (leading to potential further damage and scarring) in the area.
Ice should be applied at 15-20 minute intervals only, with at least an hour and a half in between icings.
Ice should be used for the first 48-72 hours following injury. Never use heat during this time.
Ice can also be used to alleviate pain associated with chronic back pain. Ice should be used after exercising, especially strenuous exercise, but NEVER before stretching or exercising. As ice causes increased muscle constriction and tension, its use before physical activity can lead to injury.
When to use HEAT:
Heat is used to relax and relieve tension associated with muscular stiffness and tension. It is best used to treat chronic, consistent back, neck and/or other musculoskeletal pain.
Heat can be applied before stretching and exercising to eliminate muscular stiffness and spasms. Relaxed/ looser muscles lead to increased flexibility and decreased chance of injury.
As with ice, only apply heat at 15 minute intervals and protect your skin from direct heat exposure. Warm towels or compresses work best.
These are just basic rules of thumb for treating back pain with heat or ice. If you have been diagnosed with an auto-immune disease, always discuss heat and ice therapies with your Rheumatologist or specialist. If you find that ice and/or heat seem to intensify your pain, avoid its use and consult with treating practitioner.
If you feel your back pain is interfering with your quality of life or your ability to function in your daily life, you would probably benefit from skilled therapy, or a treatment protocol, such as Functional Disc Rehydration therapy.