What You Should Know About Ice & Heat for Lower Back Pain

Using both ice or heat for lower back pain can provide effective relief, but it’s important to understand how and when to properly use these therapies. Each has its own unique properties, and they work differently when alleviating pain. Keep reading to learn how to correctly use hot and cold therapy for your lower back.

When & How to Use Ice on Your Lower Back

Cold (Cryo) therapy is most effective 24 to 72 hours after sustaining a lower back injury. This will help to relieve pain by reducing swelling and minimizing inflammation along with numbing the lumbar area. If it’s been over 72 hours, continued cold therapy is still beneficial and simple to do.

Best Types of Cold Therapy for Lower Back Pain Relief

• Reusable Cold Packs or Compresses - these can be applied locally to the lower back area (a frozen bag of vegetables or frozen towel work just a well).
• Cooling Topical Gels - an alternative to ice packs and can be rubbed directly on the lower back to target and reduce inflammation. 
• Ice Massage - the combination of cold therapy and massage working together. Massage balls that can be frozen are perfect for this and can also be used while stretching.
• Ice Therapy Machines - this device consists of a water basin filled with ice water + hose that delivers constant cold relief to a flexible therapy pad that can be wrapped around your lower back.
• Ice Baths - often used in sports therapy, these allow you to fully submerge your back in ice cold water temperatures for a short duration of time.
• Whole Body Chambers - with the help of liquid nitrogen, these chambers drop to around -184 degrees fahrenheit to effectively reduce inflammation along with many other benefits.

Tips for Lower Back Pain Cold Treatment

For at home cold therapy, follow these general tips below:

• Use to reduce swelling and inflammation
• Avoid Ice burn
  • Apply cold for no more than 20 minutes.
  • Do not apply directly to skin, use a towel or thin clothing as a barrier
• Try lying on your stomach to keep the ice pack from slipping off the targeted area or utilize a gel pack designed with straps to wrap around your waist and hold in place.
• Repeat 8 to 10 times throughout the day
• Avoid using ice and cold packs for muscle spasms or muscular tension, as it can make these conditions worse

When & How to Use Heat on Your Lower Back

Either dry or moist heat is used to loosen stiff or tight muscles and should only be applied to the lower back once initial swelling has decreased. This increases blood flow, bringing fresh oxygen and nutrients to the muscles, and it carries away waste products—all of which speed up healing and alleviate discomfort.

Best Types of Heat Therapy for Lower Back Pain Relief

• Dry Heat

  Dry heat is easier to apply than moist, and pulls moisture from the body - which can sometimes dry out the skin. The most common forms of dry heat application for lower back pain include:

• Electric heating pads
• Saunas

• Moist Heat

  Moist heat penetrates the lower back tissues more efficiently. The most common forms of moist heat application for the lower back include:

• Hot & cold gel pack wraps
• Hot water bottles
• Warm compresses or heated towels
• Hot tubs, baths and steam rooms

Tips for Heat and Lower Back Pain

For at home heat therapy, follow these general tips:

• Do not use for swelling or inflammation
• Temperature should be “warm” and not at risk of burning your skin. Use a soft towel or clothing as a barrier between your skin and heat source.
• Typically, heat is applied for longer sessions than ice.
  • For minor low back aches, aim for 15 to 20 minutes.
  • More severe or chronic back pain can be treated with heat anywhere from 30 minutes to 2+ hours
  • Take 20 minute breaks in between sessions
• Apply a heat pack before exercising or stretching out the lower back as heat loosens up tight muscles, which may reduce the risk of injury.

Alternating Hot and Cold Therapy on the Lower Back

Used individually, hot and cold therapies provide many benefits for those with lower back pain. Some people find that alternating the two is even more effective than using either in isolation. This practice is known as contrast therapy.

To enjoy the benefits of contrast therapy, you should aim to use one minute of cold therapy for every three minutes of heat application. Alternate between the two several times and always begin and end with ice. For more information, check out our Ultimate Resource guide on alternating hot and cold therapy.

• Alternating Hot and Cold Therapy - The Ultimate Resource

When to Avoid Hot and Cold Therapy

Under certain circumstances, you may need to avoid using cold therapy, heat therapy or both for your lower back pain. If you suffer from any of the following, we always recommend that you talk with your doctor to determine best practices for you.

• Open wounds, dermatitis, blisters or rashes
• Impaired sensations
• Diabetes
• DVT
• Other circulatory problems

Precautions When Relieving Back Pain with Ice and Heat

When looking for relief from your lower back pain, finding a good balance of using hot and cold therapy AND using them at the right time is key. Remember to take precaution when applying both cold and heat to your skin. Depending on the source and degree of pain your experiencing, treatment regimens may vary. Always discuss with your doctor to formulate a plan that works best for you, especially if you’ve been experiencing prolonged or chronic lower back pain.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808259/

https://www.ncbi.nlm.nih.gov/pubmed/17023239