Ask Dr. Mundrati: How Do I Use Heat And Ice?
When your back hurts, Dr. Mundrati explains how to use heat and ice safely for pain relief.
When your back hurts, heat and ice treatments are an easy and convenient way to get pain relief fast. But when do heat and ice do more harm than good? Dr. Pooja Mundrati explains how to safely use heat and ice to relieve back pain.
“As a physical medicine and rehab physician, I expect that my patients will have questions about heat and ice,” says Dr. Pooja Mundrati. “I think part of the confusion stems from the fact that patients hear different things from different physicians. I understand; conflicting information is confusing. And I think patients are afraid of doing something harmful. I’m happy to reassure them and explain how to use heat and ice when you are in pain.”
How do heat and ice work on pain?
“The philosophy about using heat is that it loosens connective tissue and tight muscles,” Dr. Mundrati explains. “Also, it brings blood flow to the muscles. This is why heat is frequently recommended before you stretch or work out. Heat ensures that you won’t injure yourself by stretching a cold muscle.”
Ice, conversely, acts to contract tissues. This is why it is often recommended after activity, to ease inflammation. “You’d also be more likely to use ice immediately after an injury, to control swelling,” Dr. Mundrati notes.
Dr. Mundrati’s philosophy for using heat and ice
“Generally, you can apply heat prior to stretching to help relax the tissues,” says Dr. Mundrati. “On the other hand, if you’ve been exercising and your back feels stiff or inflamed, try applying ice. That is the general overall philosophy. But at the end of the day, trust your own body. I’ve had patients who say heat always makes them feel worse and ice makes them feel better.”
Recommended heat and ice sources
“There are a variety of ways to apply heat and ice,” says Dr. Mundrati. “I don’t have a strong recommendation for one option over another. It’s fine to use whatever works and is convenient. A bag of frozen peas is fine. Patients who can afford a specialized source can certainly purchase dual hot and cold pads. And moist heat can sometimes reach the tissues better. But when all is said and done, heat is heat.”
Use heat carefully
She cautions that there are a few safety measures to keep in mind when using heat. “It is important never to go to sleep with a heating pad unless it has an automatic shutoff,” she notes.
Also, incorrect use of a heating pad can cause problems.
- Chronic use of a heating pad when you sleep can leave skin patterns that won’t go away
- Falling asleep with a sleeping pad can also cause burn injuries.
Dr. Mundrati has one caution when deciding whether to use heat or ice
“You can use a hot or a cold pack for back pain,” says Dr. Mundrati. “My only caution is about using ice right before you stretch or exercise. Don’t stretch a cold muscle. Use heat and not ice to prepare muscles for exercise. The heat can be in the form of a hot shower, a heating pad, or gentle stretching. Just make sure you warm up cold muscles before you begin strenuous exercise.”
By following these simple guidelines and listening to your body, you can safely and conveniently use heat and ice to soothe your back pain at home.
More resources for you
Ask the Expert: Spine Video Series
Meet the Expert: Doctor Bio Video Series
Regenerative PRP and BMAC therapies offer promising options for pain relief and improved function.