What You Should Know About Ice & Heat for Lower Back Pain

What You Should Know About Ice & Heat for Lower Back Pain

If you are experiencing back pain, you may question whether ice or heat is more effective in treating the discomfort. The appropriate treatment depends on the underlying cause of the back pain and its location. While heat or ice may be beneficial in certain cases, they may exacerbate pain in other instances.

Using hot or cold therapy can help alleviate pain in your lower back, but it is also essential to understand when and how to use them best. Ice and heat have unique properties and work differently when treating pain. Keep reading to learn the correct times for each type of therapy if you need relief.

When & How to Use Cold on Your Lower Back

Sometimes, back pain lingers for days and weeks. If a person has been suffering from back pain for over three to four days, the chance is good that the back injury will only spread—and probably increase in intensity. People can help relieve their lower back or sciatica symptoms through a new form of therapy called cryotherapy.

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    Cold (cryotherapy) therapy is most effective about 24 to 72 hours after sustaining a lower back injury. This will help relieve pain by reducing swelling, minimizing inflammation, and numbing the lumbar area. If this has passed, it's still beneficial and easy to do cold therapy if you've been enduring for over 72 hours.

    Best Types of Cold Therapy for Lower Back Pain Relief

    Reusable Cold Packs or Compresses

    Reusable cold packs are an easy way to help reduce back pain and swelling in your feet when they feel achy. If you don't have any ready-made cubes and only need to use them on and off, try using plastic zippered bags filled with ice or cold therapy sacks.

    Cooling Topical Gels

    Cooling topical gels are a great alternative to ice packs that can be rubbed directly on the lower back to target and reduce inflammation. However, avoiding any cooling method is essential, or it could burn your skin too much - especially on anyone with sensitive skin around the lower back area.

    Ice Massage

    Ice massage is a unique way of getting rid of sore muscles and those fussy aches and pains in other body areas. It can mainly treat joint stiffness, sprains, and bruises, making it an effective form of physical therapy. Therefore, it should be used by medical professionals and athletes who must endure rigorous training sessions.

    ice Baths

    You may be advised to take an ice bath to recover from a back injury. It is done by allowing your back to enter chilled water for anywhere between 10-20 minutes, depending on medical advice and specific needs related to recovery.

    Tips for Lower Back Pain Cold Treatment

    For at-home cold therapy, follow these general tips below:

    Avoid Ice burn

    • Apply the cold for no more than 20 minutes.
    • Do not apply directly to the skin; use a towel or thin clothing as a barrier.
    • Use to reduce swelling and inflammation.
    • Repeat 8 to 10 times throughout the day.
    • Hold an ice pack in place on the injured area by lying down on your stomach, use a gel pack to secure the injury site, or strap an ice pack onto the part of your body that you need to treat.
    • Never use ice and cold packs to treat spasms or muscular tension. Instead, these products can cause muscle tissue to constrict, thus making already tight muscles in the area even faster.

    When & How to Use Heat on Your Lower Back

    Sometimes, people have to deal with a few aches and pains or a full-blown injury. As such, they may need some physical therapy to help relieve the discomfort or pain. Moist heat and dry heat therapy can relieve deep muscle pain and stiffness. Sweltering heat focuses on the superficial layers of muscles, so don't worry about getting wet.

    This heat helps loosen tight muscles and is excellent for any pulled muscle to regain shape! Dry heat helps reduce stiff muscles by releasing tension in deeper tissues that would otherwise remain trapped to cause an injury, as well as removing waste products and blood from these tissues, speeding up the healing where you've strained it!

    Best Types of Heat Therapy for Lower Back Pain Relief

    Dry Heat

    The most effective way to relieve back pain is by administering dry heat. The heat of the steam increases blood flow to the affected part of your body and makes muscle contractions more effective. While it initially sounds counterintuitive, spending time in a sauna offers excellent relief.

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      Applying dry heat, such as a hot pack wrapped around the back, helps draw moisture from the body, sometimes alleviating pain. One of the most common forms of applying dry heat to relieve back pain is using a hot bag or wrap placed against the affected area.

      Moist Heat

      Individuals with lower back pain usually find moist heat to be more effective than dry. The most popular ways of applying sweltering heat to the lower back are:

      • Hot water bottles
      • Warm compresses or heated towels
      • Hot tubs, baths, and steam rooms

      Tips for Heat and Lower Back Pain

      For at-home heat therapy, follow these general tips:

      • The temperature should be "warm" and not at risk of burning your skin. Use a soft towel or clothing as a barrier between your skin and the heat source.

      Typically, heat is applied for more extended sessions than ice.

      • For minor low backaches, aim for 15 to 20 minutes.
      • More severe or chronic back pain can be treated with heat anywhere from 30 minutes to 2+ hours.
      • Take 20-minute breaks in between sessions
      • Do not use for swelling or inflammation

      Alternating Hot and Cold Therapy on the Lower Back

      Both hot and cold therapies are effective for lower back pain, but some people find that the most effective method is alternating between one treatment and the other. This is known as contrast therapy.

      For example, after being under a cold compress for twenty minutes, you can place two twenty-minute periods of heat on any musculature in your lower back or upper leg area.

      However, it's essential to be mindful of any possible interactions between these modalities and medications you may also need or be taking. Always consult your primary healthcare provider beforehand!

      One should alternate between applying heat and cold to one's skin to enjoy the benefits of contrast therapy.

      Alternate between the two, and always make sure to start and end with cold, though! Stay consistent with cold or heat for about 3 minutes to get the most out of contrast therapy.

      Precautions When Relieving Back Pain with Ice and Heat

      When suffering from lower back pain, you must find the right balance between using hot and cold therapy (Hot and cold) and the right time to use them. It's essential to do this because only then will Hot and cold therapy be most effective in relieving your lower back pain.

      However, take precautions when applying them to your skin—if misused or without control, Hot and cold therapy can cause more harm than good! If you're currently experiencing chronic lower back pain and are looking for relief, why not consult your doctor first and see what they recommend; doctors are experienced with all kinds of treatment regimens.

      There are three guidelines for using heat and cold for different types of back pain.

      When treating lower back pain, it is important to consider which therapy may be most effective for the specific condition. While personal preference may play a role in therapy selection, certain conditions may require a specific approach for optimal results. Below are some common examples of lower back pain and the recommended therapy for each.

      1. Use cold first and then apply heat for acute back pain.

      For individuals experiencing acute back pain (lasting less than four weeks) or pain caused by direct injury, it is recommended to begin with cold therapy. This treatment method reduces swelling and inflammation and causes a numbing effect by constricting blood vessels. 

      Once the inflammation has decreased, heat therapy can improve the flexibility of soft tissues, muscle movement, and overall back function. In addition, heat promotes blood circulation in the lower back, providing essential healing nutrients to injured tissues. 

      It is important to continue using heat therapy intermittently for several hours or days to enhance tissue healing and prevent pain recurrence.

      2. Ice your back immediately after exercise to reduce muscle soreness.

      It is common to experience muscle soreness and back pain after extensive workouts, trying a new workout routine, or even after excessive walking. This discomfort may begin on the first day and often peaks on the third day due to delayed onset muscle soreness. This condition can cause significant inflammation and pain in your back.

      To alleviate back pain caused by exercise, it is recommended to use cold therapy immediately after the activity to reduce tissue damage, inflammation, and pain. After 24 hours, use heat therapy to promote tissue healing.

      3. Try continuous, low-level heat for subacute or chronic back pain.

      If you suffer from chronic or subacute back pain (more than four weeks), Apply the heat therapy with a product like a Sacksythyme hot therapy heating pad that can provide ongoing warmth. For instance,

      • Keep a heated or warm blanket wrapped around your back to keep it warm. 
      • Use a commercial adhesive wrap that adheres to the lower back of your body and gives you many hours of low-level heating.

      When you use continuous low-level heat, ensure that you follow the directions on the package to avoid injury to the skin.

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      These techniques provide closed heat on the back area, helping to promote healing and stimulation.

      General Tips for Using Heat and Cold for Lower Back Pain:

      • Always wrap cold or heat sources in a towel or cloth. Never apply ice or heat directly to the skin.
      • Avoid using cold packs for more than 20 minutes at a time: Overuse of ice can damage the skin.
      • Use heat for up to 30 minutes at a time: Overuse of heat can cause skin burns.
      • Listen to your body: If ice or heat is causing pain or discomfort, stop using it.
      • Consult your doctor: If your lower back pain is severe or does not improve with home treatment, see your doctor to rule out any underlying medical conditions.

      Here's a summary of when to use ice and heat for lower back pain:



      Acute injuries


      Muscle strains or spasms


      Acute inflammation


      Chronic pain


      Muscle stiffness


      Chronic inflammation


      The bottom line

      It is common for individuals to experience back pain at some point in their lives. Dealing with the slow recovery or impairment in daily activities can be a frustrating experience. Ice packs can relieve pain and inflammation in the initial few days if you are experiencing muscle soreness or strain due to a workout or injury. Heat is a more suitable option to help alleviate pain and improve mobility as the days pass. 

      While rest is essential for the healing process, incorporating small movements into your daily routine can be beneficial in regaining strength and flexibility in your back. Focusing on small, incremental improvements daily is crucial, and setbacks should not discourage you. Instead, give your body the time it needs to recover.

      When to see a healthcare provider,

      Back pain alleviation can often be achieved through gentle physical activity and over-the-counter pain relief medications such as ibuprofen (Advil) or naproxen (Aleve). 

      However, it is crucial to recognize and take immediate action in response to certain symptoms that may indicate a more severe underlying condition than typical back pain. It is recommended to seek medical attention without delay if you experience any of the following symptoms:

      • Pain that’s worsening and does not improve with repositioning
      • Any leakage of stool or feeling like you can't control your bowels
      • Weakness or numbness in one or both legs 
      • Numbness in the groin and perineum (the area around the genitals) 
      • Shooting pain down your legs   
      • Pain that significantly limits your mobility
      • Trouble urinating

      "This article is for informational purposes only and is not intended as medical advice. Always consult your physician to determine a treatment plan that is right for you."

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