Ice Versus Heat for Back Pain

Ice Versus Heat for Back Pain


Hi this is dr. John Shim and today I
want to talk about a very common and controversial topic, and that’s the use
of ice versus heat for back pain. We all know that for acute injuries such
as sprained ankles or twisted knees using ice is the preferred method it
decreases inflammation decreases the pain and in contrast in these acute
horrible sprains and strains and even breaks if you use heat you actually
increase the inflammation may actually cause more pain and discomfort. Well does
that apply to your back? Well, it turns out it’s relatively controversial but in
my opinion if you think you really pulled or stretch the muscle or tendon
or ligament of your back and it’s really very very painful
I do think ice is a benefit to you. Ice has that property of cooling the skin
therefore cooling some of the nerves. Ice also has that property of decreasing the
inflammation so it could be beneficial for you, but there are some cautions to
must take when we use ice. Never put ice directly on the skin because it could
potentially cause frostbite. Always use something like a towel barrier and
do not apply it on the skin for more than 10 or 20 minutes at a time. You
can’t repeat it as often as you like after you give some recovery time to
your skin. When you use ice make sure you rest during that period of icing. I
can’t tell you how many times I see people walking around with ice packs or
doing work with ice packs still pushing stretching pulling on their muscles. In a
way you’re kind of defeating the purpose of using the ice because the ice are
there to decrease the inflammation swelling. If you keep pulling and tugging
you’re actually flaring up the situation. Get some rest during the period of using
ice. Ice packs can be gel packs frozen towels or even a package of frozen peas.
Folks with certain medical conditions such as Raynaud’s disease, loss of
sensation to the area, or paralysis should avoid ice therapy. Studies have
shown ice can be beneficial but more studies need to be done. Now I want to switch gears and talk
about the use of heat. It turns out heat therapy can be beneficial for chronic
back pain and stiffness but not for acute injury. Remember that as I talked
before in acute injuries you can actually increase the swelling and
inflammation. In chronic conditions chronic stiffness heat can help dilate the
blood vessels and deliver more nutrients to the sore and stiff area. Heat
helps stretch the softer tissues including the muscles, ligaments, tendons
and it eases stiffness. Forms of heat include a hot water bottle use of a
sauna or a warm bath. For those with loss of sensation or paralysis you have to
use caution because it can be too hot or you won’t feel how hot that area would
be. Remember not to apply a hot water bottle for more than 20 minutes at a
time and use some common sense and don’t stay in a Sode up for more than 15 to 20
minutes. Always check your water temperatures both with the water bottle
and before getting into the bathtub. Studies have shown some limited benefit
to heat therapy and more studies need to be done to prove its benefit. An
alternative treatment is to rotate cold and heat therapy every 15 to 20 minutes
for chronic conditions but remember the general principle, avoid heat for acute
injuries use heat for chronic stiffness and chronic arthritis type conditions.
This is Dr. Shim talking about the use of heat versus cold and treating back
pain. Thank you for listening.

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