Generally speaking, ice is better than heat for back pain that may be caused by an acute injury. The Cleveland Clinic says that, in the battle of back pain, “Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.”
Which is used first, heat or ice, when treating pain from a slipped disk? Heat and ice can be used to treat the symptoms of pain associated with the muscle spasm from a cervical herniated disc. As a general rule, use ice for the first 24 hours after this injury and then use whichever feels better after that.
Heat Therapy
The application of heat can help ease muscle spasms resulting from a herniated disc. Since spasms in the large muscles of the lower back can be especially painful, heat therapy may be a smart option.
The short answer: Start with ice when your back hurts after a minor injury. Cold therapy helps most right after you experience pain and up to the first 2 days. Afterward, heat will likely give you more pain relief. Plus, heat will help with stiffness and loosen up your muscles and joints.
Heat or ice therapy can be an effective treatment option for back pain. Cold treatment can reduce inflammation of the muscles, while heat treatment can promote the healing and relaxation of damaged muscles.
If you have truly pulled or strained your lower back muscles, applying heat will cause inflammation. Heating inflamed tissues will make your pain worse and certainly won't help things get better any time soon. Another scenario when heat therapy is not a good idea is if you are already sweating.
“Heat actually has the opposite effect of ice,” Dr. Behr says. “It causes small blood vessels to open which can stimulate inflammation rather than relieve it.” Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.
Radiating pain
Strained muscles cause localized pain (at the site of the injury), but the pain can sometimes radiate to your buttocks. However, if you find that your pain runs from your buttocks and down through your leg, you might be dealing with sciatica or even a herniated disc in your lumbar spine.
While patients often say they're successful in alleviating the pain from sciatica with a heating pad or hot shower, this isn't the right approach. Why? You're only temporarily relieving your pain symptoms because the heat causes fluid to build up, as well as more inflammation, that will eventually make pain worse.
When to Use Heat for Back Pain. On the other hand, if you have chronic back pain, heat may be better than ice. The Cleveland Clinic indicates that “If you're dealing with lingering injuries (older than 6 weeks) then it's okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints.
Heat therapy may be best after those first 48 hours, as heat helps to relieve painful muscle spasms. Methods for applying heat include taking a warm bath, using a wrap that applies continuous low-level heat to the area, or by using a heating pad.
Your symptoms feel worse when you bend or straighten up from a bent position. Movement can increase pressure on the herniated disc and the surrounding nerves, causing symptoms to increase. Many people find that sitting or lying in specific positions makes their pain worse as well.
Relieve inflammation
For mild herniated disc pain, relieve the inflammation to decrease pain. For instance, applying a heating pad or ice pack to the affected area may be a good way to temporarily relieve your pain and reduce inflammation.
Daily walks are an excellent way to exercise with a herniated disc, without putting additional strain on your spine and causing painful symptoms to flare up.
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Try cold packs initially to reduce inflammation. Apply an ice pack to the painful areas for about 20 minutes several times a day. After two or three days, apply heat with a heat lamp or a heating pad on the lowest setting. Alternating warm and cold packs may provide some relief.
To use, rub the ointment, gel or cream near where it hurts. It's also important to apply the product to the rear pelvis – the area that's closest to the sciatic nerve root. Sciatica starts at the nerve root, so if you're able to stop the pain there, you may be able to stop it from spreading.
According to Spine Universe, chiropractic care is a non-surgical option for herniated disc treatment. This makes choosing a chiropractor to address problems with a herniated disc a viable option if you want to avoid undergoing any surgical procedures.
If you have a herniated lumbar disc, you may feel pain that radiates from your low back area, down one or both legs, and sometimes into your feet (called sciatica). You may feel a pain like an electric shock that is severe whether you stand, walk, or sit.
Most disc bulges resolve in 6-8 weeks, but it can take longer depending on the size of the bulge (i.e. if the bulge is hitting the nerve behind it like described above).
Ice wins to shut down swelling, inflammation and pain early on where heat may actually make an injury worse.” If you're dealing with lingering injuries (older than 6 weeks) then it's okay to use heat. The increased blood flow relaxes tight muscles and relieves aching joints.
After an acute injury, ice should be used to minimize swelling for the first two to three days. After this period, heat can be used to increase blood flow and assist the natural healing process. Applying heat too early may cause additional swelling by increasing blood flow to the injury.
Ice helps reduce inflammation and numb pain, whereas heat helps relax muscles and stiff joints. While heat helps improve circulation and blood flow, ice reduces blood flow thereby reducing inflammation and swelling.