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Heat, ice & rest for back pain and injury

At a Glance

  • Heat, rest and ice make up the simplest self-treatment options for back conditions.
  • Unfortunately, many people misuse these treatments, sometimes causing more harm than good.
  • Heat warms and loosens tissue and muscle prior to exercise; ice treats Sprains and Strains, as well as Spondylolisthesis; and rest treats Sprains and Strains.
  • In general, use ice immediately after an injury and as part of a comprehensive treatment program; use heat only to warm up muscles prior to exercise or physical therapy; and rest an injured area to reduce swelling and pain.

 

Heat

Heat treatments such as hot packs and electric heating pads have limited use. The only time heat should be used is to warm up tissue and muscle prior to exercise or physical therapy. This improves blood flow.

Heat treatment prior to physical activity should be followed by ice after the exercise or therapy.

Because heat increases blood flow and swelling, its application will actually increase pain and swelling during the acute phase of injury or post-surgery. This can further damage tissue.

Moist heat treatment is best, and can be delivered by hot packs or a therapeutic hot tub. Avoid electric heating pads, which are dry heat with a higher potential to cause severe burns.

Other forms of heat therapy are available through physical therapy but require a prescription in most cases. These include ultrasound (using high-energy sound waves above the human range of hearing to warm the affected area), cold laser (using a low-energy laser beam for light tissue penetration), and iontophoresis (the application of anti-inflammatory medication through a low-intensity electric current).

Ice

Ice is Mother Nature’s great healer. Unlike heat, ice treatment rarely causes injury and also works as a local anesthetic and can be an integral part of a comprehensive treatment program for musculoskeletal problems.

Ice therapy restricts blood flow, decreases swelling, and minimizes inflammation that produces noxious chemicals in injured tissues. Ice should always be used initially to treat pain, swelling and inflammation, especially after an injury, sports activity, exercise program, or an operation.

It is easy to administer ice therapy locally to the affected area by using ice cubes in a towel, freezer jelly bags, disposable chemical bags, or cold topical gels. Electric devices are also available for circulating ice water through tubes incorporated into a soft Velcro wrap.

Ice-water immersion in a small bucket or tub can be effective for ankle and wrist sprains. However, total-body immersion in a bathtub of ice water can be much riskier.

Avoid total-body immersion if there is a history of heart disease, high blood pressure, peripheral vascular disease, kidney disease or lung disease. Ice tub immersion will dangerously aggravate those conditions.

Rest

A certain amount of rest allows pain and swelling to subside after a back injury, whether from trauma, exercise, a sports mishap, or an operation.

The concept of rest does not necessarily mean to stay in bed, although sometimes this is necessary. Rest in the context of an injury often means avoiding strenuous activities that can aggravate the problem, thereby causing more pain, inflammation and swelling to the injured area.

Rest should be part of a comprehensive treatment program that allows gradual return to normal function and activities. Too much rest will cause muscle weakness, de-conditioning and loss of endurance.

It doesn’t take long for physical function to deteriorate, but it usually takes a long time to get it back. The traditional advice of bed rest for three to four weeks after a back injury or spine operation is a fallacy. Our bodies need activity – the right kind of rehabilitative activity – to stimulate healing.

Frequently Asked Questions

When should I use heat as a treatment?
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