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Do Heat and Cold Therapies Help Back Pain?

ice pack on backYes, but each has its own place in the healing process. For more intense pain, like pain that results from a fall, cold therapy is likely to be the more effective way to reduce swelling, lessen inflammation and numb pain. For pain that lingers, applying heat is usually the right choice for soothing pain and getting the healing process moving.

There are also situations when using both hot and cold therapies maximizes the chances of success. For example, after you’ve exercised, using cold therapy right away can reduce muscle soreness. Then, after a day or so, making the change to heat therapy can help muscles heal faster

So, in general, it’s wise to ice when you’re dealing with more acute injuries or pain, along with inflammation and swelling. Heat is the way to go with muscle pain or stiffness.

The Way Heat Therapy Works

By increasing the temperature around a problem area, heat therapy improves circulation and blood flow to that area, increasing muscle flexibility and healing damaged tissue.

Dry Heat vs Moist Heat

We have the option to use either dry heat and moist heat. (Whichever one you use, “warm” is the temperature to achieve, and not “hot.”)  Dry heat is applied with heating pads, dry heating packs, or sometimes by using a sauna. Moist heat results from the use of steamed towels, moist heating packs, or hot baths.

When Not to Use Heat

Be aware, there are times when heat therapy should be avoided, like when the area in question is bruised or swollen (or both). This is probably the time to use cold therapy. Also, heat therapy is the wrong choice when there is an open wound.

Also, if you have certain pre-existing conditions, you should avoid heat therapy because of the higher risk of burns or complications due to heat application. These conditions include:

  • diabetes
  • dermatitis
  • vascular diseases
  • deep vein thrombosis
  • multiple sclerosis (MS)

When you have heart disease or hypertension, check with your medical provider before using heat therapy. If you are pregnant, you will also want to talk to your provider before using saunas or hot tubs.

Applying Heat

Heat therapy gives you better results when used for a good amount of time, unlike cold therapy, which needs to be limited.

Minor stiffness or tension can often be relieved with only 15 to 20 minutes of heat therapy.

Moderate to severe pain can benefit from longer sessions of heat therapy like a warm bath, lasting from thirty minutes to a couple of hours. 

The Way Cold Therapy Works

Cold therapy reduces blood flow to a particular area, which can reduce the inflammation and swelling that causes pain, especially around a joint or a tendon. In addition, it can temporarily reduce nerve activity, which can also provide pain relief.


There are multiple ways to apply cold therapy, including:

  • ice packs or frozen gel packs
  • coolant sprays
  • ice massage
  • ice baths

When Not to Use Cold

If you suffer from a sensory disorder that keeps you from feeling certain sensations, don’t use cold therapy at home. You may be unable to feel if damage is occurring. This includes diabetes, which can result in nerve damage and diminished sensitivity.

Don’t use cold therapy on stiff muscles or joints.

Don’t use cold therapy if you have poor circulation.

*Please Note: Information on this site or any recommended sites should not be used as a diagnosis or a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
Blue Distinction Center for Spine Surgery