Should I Use Ice or Heat??

A very common question I get asked in my clinic is:

Should I use ice or heat to ease my back pain?”

Right or wrong, 9 out of 10 of my clients tend to favor heat – a nice hot water bottle, a hot shower or a heating pad to try and ease their back pain.

I think one of the key reasons is the simple fact that heat is way more comfortable for most people than ice.

As you can appreciate, every health concern and injury is different. Sometimes it’s ice to cool it down, or heat to help relax it… It can be very confusing!

So When to Use Ice?

There’s one rule of thumb that I ALWAYS use for recommended use of ice – and that is IF you JUST got injured and your back (or any area for that matter) is very painful, likely hot and maybe beginning to swell.

When it comes to your back pain, the time to use ice is if your back has suddenly ‘gone out’ and you’re in a lot a pain, or you’ve performed a repetitive movement (ie. bending or lifting) and feel as if you’ve “overdone it” and your back becomes very painful later in the day.

You see, your body is actually very clever. Let’s use an ankle sprain as an example… When you sprain your ankle your body will immediately try and protect itself. This is why you get swelling and it becomes very hot and painful, which is your bodies way of saying “stop using and abusing me!”.

The swelling is just your body’s natural cushion to protect the sprain. The pain and heat comes from the inflammation. Again this is your body’s way of trying to protect and heal itself, if something’s painful – you’re not going to want to move it or touch it are you?

The exact same thing happens in your back too, you just can’t see it. So, your ankle, back, or whatever you’ve hurt can start to heal without any more damage. So that’s WHY it happens. But this pain can be severe and worse than the actual injury itself, so cooling it down with ice is a simple method to help ease the intensity of the pain as soon as possible.

And by using the cool ice little and often on the injury (20 mins every hour or so), the cooling and warming of the injury will help the blood keep flowing around the area to help it heal even quicker.

Make sense?

Ok, so now we’ve got an idea of when’s the best time to use ice…

When Do We Use Heat?

Think of it like this… When something is warm it’s softer, and when something is cold, it’s harder (think of chocolate – frozen = hard and hot = melted)… It’s exactly the same with our body too.

SO, keeping that in mind, it’s time to apply heat when you feel more stiff, achy and need to get things moving – that’s the perfect time to use heat.

So first thing on a morning if your back’s feeling really stiff and tight, a hot shower to loosen the muscles also works wonders. Follow that with some gentle stretches too and you’ll feel a huge difference!

Typically if it’s something that’s been nagging you for some time (chronic), and it’s more stiff and achy rather than painful then heat is the way to go. They reason it’s stiff and aching is because the muscle and joints are so tight.

Like anything, you warm it up and it becomes more supple. It’s exactly the same with your joints and muscles… Muscles should be able to move, if they are stiff and tight you are more likely to have an injury by over stretching them as they simply cannot stretch as far as you need them too.

This is the exact reason athletes ‘warm up’ before doing their sport – so they don’t pull a muscle! When we’re asleep at night our muscles cool down because they aren’t being used actively… So why don’t we ‘warm up’ first thing on a morning to get us ready for the day?

Don’t worry I’m not talking about 10 laps jogging around your neighborhood. Just a warm shower followed by a few minutes of simple stretches.

Not sure what stretches to do? I always recommend a couple gentle stretches to keep your back healthy and pain free.

So key things to remember –  If it’s just happened and very painful – Ice it!

If it’s stiff and tight – warm it up! 

For more tips like this on how to ease back pain, download your completely free guide with 9 easy ways to ease back pain:

Dean Volk PT, MPT
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