Hot and Cold Therapy in Back Pain

Something as simple as heat or cold can be helpful for back pain – and the advantages are that it’s generally an easy and cheap form of treatment, with no unpleasant side effects. Unfortunately, there have not been many clinical trials carried out on hot and cold therapy, so there is not much evidence that they do or do not work. If back pain continues for more than a few days, talk to a doctor, nurse or physiotherapist. If gel or liquid packs (whether hot or cold) become punctured, throw them out straight away.

Cold Therapy

Cold therapy (also known as cryotherapy) can help straight after a back injury, as it can reduce the inflammation in the muscles, so reducing pain. Try wrapping an ice pack – a reusable frozen gel pack, or some ice cubes or a bag of peas – in a towel or fabric cover and holding it against the injured muscle for around 10 to 20 minutes at a time, two or three times a day (or more often if it helps). Cold therapy should continue for a few days, until any bruising or swelling goes away. There are also gels, patches and sprays that include cooling ingredients like menthol, and cold compresses (towels or other pieces of fabric dipped in cold or ice water and wrung out) can help too.

It’s best to use cold therapy as soon as possible after the injury. Don’t put anything cold straight against the skin as ice can burn or damage nerves, and allow the area to warm up a little between treatments (around 20 minutes or so) before applying ice again. There are fabric wraps that tie or fix with Velcro around the body and hold a cold pack against the back.

Hot Therapy

Heat can help to relax the muscles and improves the circulation by making the blood vessels dilate (become bigger), and this can ease back pain. Heat sources include:

• a hot bath or shower
• a sauna or steam bath
• a hot water bottle
• a reusable gel hot pack – these are heated in boiling water or in the microwave (and can usually be frozen as well)
• a rice or wheat hot pack – these are heated in the microwave
• a chemical hot pack – these produce heat when the chemicals are activated. They may stick to the body like a large sticking plaster, and are usually only single use
• an electrical heating pad
• a heat wrap – a fabric wrap that fastens around the body, containing a hot pack
• an infra-red heat lamp
• a hot compress (a towel or other piece of fabric dipped in hot water)
• gels, creams, patches and sprays that include heating ingredients

Hot packs should be wrapped in a towel or fabric cover to avoid burns. Heat therapy should be applied for a few minutes to a few hours each day. Don’t use heat if muscles are swollen or inflamed, or if there is any bruising.

Make a home-made hot pack by putting rice in an old sock, tying the top off, and heating it in the microwave for a few minutes. Adding a little lavender to the rice will make it even more relaxing.