Heat or Ice for an Aching Back and Neck?


Back and neck pain are among our most common afflictions. According to most estimates, as many as 70-80% of adults will suffer back or neck pain that interferes with their daily activities at some point in their lives and 10-20% will report having back or neck pain at any given time.

“Most simple back and neck pain will resolve with self-care over a week or two,” says Interventional Pain Management Specialist Dr. Kaliq Chang with Atlantic Spine Center, “but while it is usually clear that rest and over-the-counter anti-inflammatory medication are likely to be helpful, many people are uncertain whether the application of ice or heat is called for. The fact is that both can be used to good effect but only if you know when and how to use them.”

Ice and heat complement each other and work together to relieve pain and promote healing. The general rule of thumb is to use ice immediately after an injury – in the first 24 to 48 hours – to reduce swelling and inflammation and cause a numbing effect. After the initial swelling and inflammation have subsided, switching to heat stimulates blood flow to the area and brings healing nutrients to the affected area. Heat improves the flexibility of soft tissues and muscles, and continued application for several days can aid healing and prevent pain from recurring.

How to use ice therapy?

Ice constricts blood vessels and limits the flow of blood to the injured area. This relieves the pressure within the tissue and at the same time slows down the nerve impulses that transmit pain, acting as a local anesthetic to numb the injured tissues.

Whether you use a frozen gel pack or a bag of frozen vegetables, never apply ice directly to the skin. Wrap the cold source in a light towel to prevent ice burn. Apply cold therapy for no more than 15-20 minutes at a time and wait at least an hour before re-applying.

How to use heat therapy?

Heat loosens the muscles and reduces stiffness. You can use dry or moist heat. Dry heat in the form of a heat wrap, heating pad, or heated blanket may be easier to apply but may have a dehydrating effect. Moist heat, like a shower or soak in warm (but not hot) water may penetrate the muscles better and provide more relief.

When NOT to use ice or heat on an injury?

Never apply ice or cold to an open wound or if bleeding or oozing are present at the site of the injury. Consult your doctor if you have a chronic condition such as diabetes, multiple sclerosis, rheumatoid arthritis, or poor circulation.

“The best remedy for back and neck pain is to adjust your everyday activities to prevent injury,” says Dr. Chang. “Incorporate exercises that strengthen the core muscles that support the back and gentle range-of-motion exercises that strengthen stiff neck muscles. And remember to warm up before exercising. Muscles that are tight and taut are more prone to injury than those that are stretched and loosened. Make sure to cool down after exercising. Use ice to reduce any inflammation. Judicious use of heat and cold can help keep your back and neck flexible and pain free for the long run.”