Hot or cold for Back Pain: Answer found here!

Hot or Cold for Healing Back Pain

Never use a hot pack, hot tub or heating pad during the first three weeks of a lower back pain injury.

During the first three weeks your condition is considered to be in it's "acute stage".

The application of a heat modality during the acute stage is considered by most medical professionals to be contra-indicated.

Applying a heat modality is likely to prolong or make your condition worse.

Consider using a cold pack or ice pack to reduce inflammation during this "acute" stage of the injury and speed up the healing process today!

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"Use Heat or Cold for Back Pain?"

The answer to whether or not you should use a hot or cold pack for healing up your painful back is; it depends.  You see, depending on whether or not your condition is acute back pain, subacute back pain or chronic back pain will dictate which modality you should be using.

It is not unusual to have many patients come into my clinic quite confused over which modality should be used first, if at all.  The reason for this confusion stems from poor advice from some general physicians, close family members, and friends who are really not knowledgeable enough to make a proper judgment call on whether to use hot or cold for back pain.

It may surprise you to find out that even your family physician may get this wrong.  And in their defense, they are just not used to giving advice on rehabilitation for a lower back pain condition.  This may be best reserved for the orthopedic surgeon and maybe your physical therapist or chiropractor.

Only Use Cold Therapy - At First

As your condition falls within the first three weeks of a back pain episode, use only a cold pack.  Due to the recent onset of inflammation in your lower back, and bleeding capillaries, you want to restrict blood flow to the region.  Adding a hot pack can make bleeding capillaries bleed even more!

The application of your cold pack should not exceed 10 to 15 minutes.  And you want a barrier between the cold pack and your skin to help prevent freezer burn (usually a thin towel or pillow case will do just fine).

All though a hot pack often feels good and relieves symptoms temporarily, you are doing a disservice to yourself and the lower back pain condition.  You may be even prolonging it.  What might take a few days to recover using a cold pack, may now take a few weeks.

Once the subacute or chronic stage of the condition is reached, a heat pack may be used to seek relief without causing greater injury to your back pain condition.

However, you may still want to use a cold back even during the subacute or chronic stages.  Since a good cold pack serves well as a natural pain killer (numbs the lumbar region) and a natural anti-inflammatory, it can be a great way to help heal your back pain faster.  Or at the very least, manage it.

So as the next time your back pain condition “flares up,” do yourself a favor and reach into the freezer for your cold pack for a faster healing response and an improved lower back.


Tommy Hoffman, P.T. By Tommy Hoffman, Licensed Physical Therapist

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