The use of ice or heat can have incredible benefits for musculoskeletal pain and injury recovery.
What are the physiological benefits of ice vs. heat:
Ice is a vasoconstrictor. This means that it causes blood vessels to constrict or become smaller. When the body experiences an injury, inflammatory chemicals are released and swelling occurs. Ice controls and decreases the number of inflammatory chemicals and swelling. This in turn can increase injury recovery times. Ice also helps to block nerve conduction which helps to block pain.
Heat is a vasodilator. This means that it causes blood vessels and arteries to dilate or become larger. This increases circulation into tissues like muscle and ligaments, which in turn gets nutrients into circulation and promotes healing of soft tissue and blood vessel relaxation.
Lower Back And Neck Problems That Can Benefit From Heat And Cold Therapy
- Lower back pain and neck pain from herniated or degenerated spinal discs, sore muscles in the spine, muscle spasms, stenosis causing pinched nerves in the spine, or arthritis, often referred to spondylitis.
- Spinal injury from a car accident, falls, sprains and strains, sports injuries, whiplash injuries.
- Upper back pain due to poor posture. Upper back pain or Thoracicalgia from poor posture is a growing problem with the advancement of computer and phone technology. Thoracicalgia causes poor posture, injury, scoliosis and even vitamin or mineral deficiencies.
- Muscle soreness or fatigue from sitting at the office desk all day.
My tip to you: Best to use heat and cold therapy intermittently, for 15 to 20 minutes on and off, with a 2-hour break in between sessions.
3 Ways To Use Heat And Cold For Back Pain Or Neck Pain
While some people may prefer to use one type of therapy over the other, certain conditions may respond better when a specific therapy is used. Here are common examples of different types of lower back pain and the therapy of choice for each.
1. Use ice for an acute injury the first 72 hours, ice for nerve pain and ice with repetitive use injuries or after activity
When your injury is acute (less than 72 hours in duration), and/or occurs due to a direct injury, use ice. Lowering the body temperature will help constrict the blood vessels, reduce swelling, and decrease inflammation. This decreases pain and increases injury recovery times.
If you get frequent pain after activities or exercise like running, tennis or golf, use ice after the activity. This is a repetitive use type of injury. Ice will bring down swelling and numb the irritated tissue. An example of this is when a baseball pitcher is taken out of the game. The medical staff and trainers immediately get the pitcher’s shoulder wrapped in ice to increase the recovery time so that he is able to pitch in the next game quickly.
After the acute phase (72 hours), switch over to heat therapy for low back pain, neck pain and other conditions. Heat improves the flexibility of muscles and ligaments, which can improve the overall functioning of the back and neck. Heat increases circulation into the soft tissue, which in turn gets nutrients into circulation and promotes healing of soft tissue, and blood vessel relaxation.
Use heat for subacute injuries (over 72 hours) or chronic back pain or neck pain.
If you have a chronic condition like sciatica, back pain, neck pain, arthritis, stenosis, or degenerative disc disease, use heat therapy.
Heat stimulates and encourages healing. The heat will soothe inflamed and sore muscles and dilate inflamed tissues and blood vessels to bring in nutrients that promote healing.
Other top questions asked by my patients recently about heat or ice:
Ice or heat for back pain with a herniated disc?
A: Ice if the herniated disc is acute and a new injury for 72 hours, or three days, then use heat.
Heat or ice for upper back pain?
A: Upper back pain is usually a chronic issue and will respond best to heat. If there is a recent injury use ice for 3 days then switch over to heat.
Can heat make back pain worse?
A: Yes, there are serious conditions that may cause low back pain such as infection, cancer, and acute injuries. If heat is used here, it may make back pain worse.
Ice or heat for a pulled muscle?
A: A pulled muscle is usually an acute injury. Ice is recommended, then heat after 72 hours.
Ice or heat first?
If you have any additional questions please feel free to get in touch here.
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Dr. Jeffrey Gerdes, D.C.