Back Pain: Should I Use Ice or Heat? 


There is a lot of confusion and uncertainty around whether or not to use ice or heat for back pain. We get asked this question all the time, so read on to see the answer.


Back Pain: Should I Use Ice or Heat?


 Here’s some things to consider:

Do you prefer the feeling of ice or heat?



 What has worked for you well in the past? Does the thought of putting something cold or hot on your back sound soothing or alarming?

Here’s why your own personal preference can play a big part…





Our Perception of Ice and Heat



Whether or not you deem it soothing or alarming can have a profound effect on how our body responds to the treatment. For example, if the thought of putting ice on your back makes you cringe you are likely to tense in response to the application, making it ineffective and potentially causing more spasm and ache in your muscles.



Conversely, you may feel ice is exactly what your back needs and the thought of cooling down your back is comforting. In this case, ice may be effective for you. This is the same when considering heat. It all relates to the brain’s perception of threat. If your brain perceives something as dangerous it is likely to cause aggravation or pain as its own safety mechanism to make you stop what you are doing.



Have a think about what sounds more comforting to you. Think back to what you have done in the past and the effect it has had.





When is it best to use ice?


Ice is generally used for acute, inflammatory type presentations where you may experience swelling, pain, redness and increased heat in the area. It is also used to treat pain and swelling post exercise. Inflammation is the body’s natural healing response and is actually an important part in the healing process.


Pain develops in the injured region as increased chemicals and fluid in the area compress surrounding tissues and nerves causing a painful sensation. Ice helps to alleviate pain by numbing the area and restricting blood flow, thereby further inflammation, to the area.


Does heat help back pain?



Heat is best used for more long standing pain and used to relax tight, overworked and spasming muscles. When muscles are spasming/contracted for a long period of time there is a build up of lactic acid which causes a painful ache. Heat has its effect by increasing blood flow to the area ridding the tissues of accumulated lactic acid and replenishing oxygen.

The vast majority of back pain is not truly traumatic. It tends to be the result of accumulative stress on the back secondary to posture, reduction in core strength and habitual movement patterns. Therefore, there is no need to avoid heat or suspect acute inflammation.

Pain is usually resultant of tight overprotective muscles with active trigger points causing a deep ache. Icing trigger points may increase the aching and burning sensation of trigger points.


Back Pain: Should I Use Ice or Heat?


In answer to the question “Is ice or heat more effective for back pain” – It really is all about your own personal preference and experiences. If you are not sure – trial both and see what is most effective for you.

Generally we would recommend applying heat for back pain. It can help sooth and relax the overprotective and spasming surrounding muscles. But it ultimately comes down to personal preference and the nature of your injury.


How can Physiotherapy help back pain?


Our approach to back pain includes 3 stages, so that we address underlying issues, and set you up for long term success. Read more about how we use Physiotherapy and exercise to overcome back pain