Is ice or heat best for back pain and what are the benefits of both and when is it best to use either modality.
A question we get commonly asked in clinic is when should I use heat and when should I use cold for my injury. Although there is not a hard and fast rule as such, the following should help. I hope you find these of benefit!
When to apply cold
It is advisable to apply cold packs as soon as possible after an acute injury as cold will help reduce the swelling and pain. It should be applied immediately after the injury and repeatedly until the swelling has gone, normally between 2-7 days.
Cold can also be used for overuse and chronic injuries such as a knee that swells up after walking or other activities. Apply the cold pack after the activity and continue with applications until the swelling has subsided.
How to apply cold
Ice is best applied using a soft cold pack, such as those sold at BOP, but if you don’t have one of these handy then a bag of peas will do. It is best not to apply an ice pack directly to the skin as this can cause it to burn, so wrap the pack or ice in a damp cloth. (“Raw” ice can, however, be applied directly to the skin if it is kept moving over the general area as it melts).
Always be careful not to wrap the ice completely around an area (e.g. tying it around an ankle) as this can cause a restriction in blood flow.
How long to apply cold
The length of time to apply ice or cold packs will vary depending on the injury site. For example a wrist will chill much more quickly (about 5 minutes) than a large area like the thigh (up to 10 minutes). If the skin is very red after the application then you may have left it on too long. Applications can be repeated every 1 – 2 hours, leaving enough time between for the skin to return to its normal temperature. Frequent applications of ice are better than longer applications. 5-10 minutes at a time repeated every few hours is a common recommendation.
When to apply heat
Heat is generally used for chronic injuries or injuries that have no inflammation – don’t apply heat within 2 days of a new acute injury unless you have been advised to do so.
Heat can help to promote healing by stimulating the circulation. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy as it can help to relax tight muscles. Heat can be applied before exercise but do not use after exercise.
How to apply heat
You could try using a special hot “wheatie” packs or a hot water bottle with a cover.
How long to apply heat
You can safely apply heat for 10 – 15 minutes every hour or two. Never leave on for more than 20 minutes, or while sleeping.