Ice and Heat for Neck and Back Pain

COLD THERAPY

HOW DOES IT WORK?

  • Cold causes the blood vessels of the muscles in the neck and back to constrict, reducing circulation and thereby inflammation and swelling.
  • Cold numbs sore tissues (providing pain relief like a local anesthetic).
  • Cold slows the nerve impulses in the area, which interrupts the pain-spasm reaction.

WHAT ARE THE TYPES?

  • Ice massage
  • Ice packs
  • Frozen gel packs
  • Cold water bottle

WHEN SHOULD YOU USE IT?

Ice massage and cold therapy is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application such as ice massage therapy provides the most pain relief. Some prefer to use heat prior to physical activity (to warm-up the muscles) and cold after activity (to decrease inflammation).

APPLYING ICE MASSAGE THERAPY

Ice massage is a very effective method of applying cold therapy. One easy way to do this is to freeze water in a paper or styrofoam cup, then peel the top inch or two of the cup to expose the ice surface. Someone else can give the ice massage, with you lying on your stomach in a comfortable position with a pillow under your hips to keep stress off your back. You can also give yourself an ice massage by lying on your side.

  • Apply the ice gently and massage in a circular motion making sure the ice doesn't stay in one place for too long.
  • Focus the ice massage therapy on a six-inch area of the back or neck where the pain is felt.
  • Avoid applying the ice massage directly on the bony portion of the spine.
  • Limit the ice massage therapy to about 5 minutes at a time (to avoid an ice burn).
  • The key to ice massage therapy is to achieve numbness in the area of injury without burning the skin.
  • When the numbness has worn off, the ice massage can be applied again for another cycle.
  • Ice massage therapy can be repeated two to three times a day.

SAFETY TIPS FOR ICE PACKS AND COLD PACKS

  • Treatment should not last more than 20 minutes.
  • Check the skin every 5 minutes to make sure there is no damage, such as a freeze burn (redness and blistering of the skin).
  • Do not place ice packs or cold packs directly on the skin; use a towel for insulation.
  • Wait 1 hour between cold treatments.
  • Cold therapy should not be used for patients who have rheumatoid arthritis, Raynaud's Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation.

HEAT THERAPY

HOW DOES IT WORK?

· Heat opens the blood vessels of the muscles surrounding the neck and back. This increases the flow of oxygen and nutrients to the muscles, helping to heal the damaged tissue

· Heat stimulates the nerve-endings in the skin, which decreases transmission of pain signals.

· Heat facilitates stretching of the muscles and ligaments around the spine, leading to a decrease in spasms, stiffness and injury, with an increase in flexibility and overall feeling of comfort

WHAT ARE THE TYPES?

  • Dry heat, such as electric heating pads and saunas, draw out moisture from the body and may leave the skin dehydrated. However, some people feel that dry heat is the easiest to apply and feels the best.
  • Moist heat, such as hot baths, steamed towels or moist heating packs can aid in the heat's penetration into the muscles, and some people feel that moist heat provides better pain relief

Some common options include:

  • Hot water bottle - tends to stay warm for 20 to 30 minutes.
  • Electric heating pad - maintains a constant level of heat as long as it is plugged in.
  • Heated gel packs - may be microwaved, or sometimes heated in water, and tend to say warm for about 30 minutes. Certain types of gel packs provide moist heat, which some people prefer.
  • Heat wraps - wraps around the lower back and waist and may be worn against the skin under clothing, providing convenience and several hours of low level of heat application.
  • Hot bath, hot tub, sauna, steam bath - tend to stimulate general feelings of comfort and relaxation that may help reduce muscle spasm and pain. A whirlpool jet directed at the lower back may provide the added benefit of a light massage.

WHEN DO YOU USE IT?

Ice massage and cold therapy is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application such as ice massage therapy provides the most pain relief. Some prefer to use heat prior to physical activity (to warm-up the muscles) and cold after activity (to decrease inflammation).

SAFETY TIPS

  • Treatment should not last more than 30 minutes.
  • During treatment, check the skin every 5 minutes to make sure it is not getting burned.
  • Do not fall asleep while lying on a heating pad to avoid potentially burning yourself.
  • Do not use heat if you have no feeling in the affected body part.
  • Do not use heat if there is swelling or bruising; cold therapy is better in these situations.
  • Do not apply hot water bottles or gel packs directly to the skin; use a towel as insulation.
  • Do not use heat if you have poor circulation, such as occurs with diabetes.
  • Do not use heat on open wounds or over stitches.
  • Do not use heat on areas of the body with dermatitis, deep vein thrombosis, or peripheral vascular disease.