“Back Pain Remedies: Heat and Ice”

How to Use Heat and Ice
One of the most common questions I get from new patients is “when do I use heat and when do I use ice?”
 
 It’s an excellent question and even some doctors or therapists get confused. Here’s the bottom line from my years of experience…
 
 If your pain is new or if you have suffered an acute strain or injury, apply ice. Continue using ice for the next 2-3 days to control swelling and pain. (See “How to Use Ice” below)
 
 If on the other hand your pain has been around for a few days or more or if you suffer from osteoarthritis, then apply moist heat. (See “How to Use Heat” below)
 
 If you are ever in doubt of which one to use, try ice first. If that doesn’t help switch to heat.
 
 Okay, so here’s and advanced tip used by professional trainers of elite athletes and the one you will hear me advise all day long in the office…
 
 Use both!
 
 If you’re pain is older than 2-3 days, then first apply moist heat, then immediately afterwards apply ice. This is a way to supercharge your body’s natural ability to reduce pain and inflammation fast! (See “How to Alternate Heat & Ice” below)

How to Use Heat
Heat is used to increase circulation to allow the body to heal itself. Blood flow brings nutrients to injured tissues so that they may be repaired and rebuilt. Heat can also significantly reduce chronic pain.

How to Use Ice
Ice is best used in the acute stage of pain or injury (the first 48-72 hours). Ice reduces swelling and inflammation. It is also good at controlling acute pain.

How to Alternate Heat & Ice
Okay, now that you have heat and ice down pat, let’s move on to Therapy 2.0.

Use heat for old pains that flare-up, pain that is more than 3 days old and for osteoarthritis.

Moist heat (moist heating pad, shower, Jacuzzi, bath, hot wet towels) are best and penetrate the deepest.

When using heat do not exceed 30 minutes duration and be sure to allow the area to cool down for at least 1 hour before re-applying heat.

Never go to bed with a heating pad! If it does not shut down you will end up burnt. Even if you do not burn, excessive heat makes the area even more inflamed resulting in more stiffness and pain.

When applying ice remember to use caution. Whether you’re using ice bags or chemical ice packs, place a sheet of paper towel between the ice and your body. Also limit ice to 12 minutes with at least 1 hour between applications.

Ice Massage: An old football trainer’s trick is to fill small Dixie cups half way up with water and freeze. Then crinkle up the top brim of the cup to use as a handle and tear off the bottom of the cup to expose the ice. Rub the exposed ice over the affected body part for 10-12 minutes.  Because the ice is melting and you are moving it around, you can get by with direct contact with ice without risking frost bite.

After the initial 24-48 hours following an injury, try this advanced technique.

Start with moist Heat for 12-15 minutes
 
Gently stretch the affected area for a few moments
 
Apply Ice for 12 minutes
 
Wait 1 hour before repeating procedure, if necessary. Always start with heat and always end with ice.