Back Pain: When Do I Use Ice?… And When Do I Use Heat?

Confused about whether you should use ice or heat to help ease your back pain?… Our Physical Therapist, Ronaldo Montecer is here to answer your question, read on!…


Easily one of the most common questions I get asked on a daily basis, and it’s something that confuses many people too…

“Should I use ice or heat to ease my back pain?”

Rightly or wrongly,  9 out of 10 of my clients tend to favor heat – a nice hot soak in the bath or one of those lavender scented bean bags to try and ease their back pain.

I think one of the key reasons is the simple fact  that during the winter, it’s just plain cold here in the Mid-atlantic and they don’t like the thought of the cold ice on their back!

As you can appreciate every health concern and injury is different. Sometimes it’s ice to cool it down, or heat to help relax it… It can be very confusing!

So when to use ice:  There’s one time in particular we say to use ice and that’s when something just happened and it’s very painful, likely hot and maybe swollen.

This is an ‘acute’ injury.  Acute meaning it just happened. For example a sprained ankle or pulled muscle.

When it comes to your back pain, the time to use ice is if your back has suddenly ‘gone’ and you’re in a lot a pain, or you’ve overdone it and your back becomes very painful towards the end of the day.

You see, your body is actually very clever. Let’s use an ankle sprain as an example… When you sprain your ankle your body will immediately try and protect itself. This is why you get swelling and it becomes very hot and painful.

The swelling is just your body’s natural cushion to protect the sprain. The pain and heat comes from the inflammation. Again this is you body’s way of trying to protect and heal itself, if something’s painful – you’re not going to want to move it or touch it are you?

The exact same thing is happening in your back too, you just can’t see it.

So your ankle, back, or whatever you’ve hurt can start to heal without any more damage. So that’s WHY it happens.  But this pain can be awfully worse than the actual injury itself, so cooling it down with ice is a simple method to help ease the intensity of the pain as soon as possible.

And by using the cool ice little and often on the injury (20 mins every hour or so), the cooling and warming of the injury will help the blood keep flowing around the area to help it heal even quicker.

Make sense?

Ok, so now we’ve got and idea of when’s the best time to use ice…

When Do We Use Heat?

Try thinking of it like this… When something is warm it’s softer, and when something is cold, it’s harder (think of that yummy chocolate bar you snuck in this weekend! Like most things, when chocolate is warm its softer)… It’s exactly the same with our bodies.

With that in mind I always explain to my clients it’s time to apply heat when you feel more stiff, achy and need to get things moving – that’s the perfect time to use heat.

So first thing on a morning if your back’s feeling really stiff and tight, a hot shower to loosen the muscles also works wonders. Follow that with some gentle stretches too and you’ll feel a huge difference!

Typically if it’s something that’s been nagging you for some time (chronic), and it’s more stiff and achy rather than painful then heat is the way to go. The reason it’s stiff and aching is because the muscles and joints are so tight.

Like anything, you warm it up and it’s more supple. It’s exactly the same with your joints and muscles… Muscles should be able to move, if they’re are stiff and tight you are more likely to have an injury by over stretching them as they simply can stretch as far as needed.

It’s for this same exact reason athletes ‘warm up’ before doing their sport – so they don’t pull a muscle!  When we’re asleep at night our muscles cool down because they aren’t being used (our blood is going directly to our brain for our dreams and to our stomach to digest our dinner)… So why don’t we ‘warm up’ first thing on a morning to get us ready for the day?

Don’t worry I’m not talking about 10 laps jogging around your neighborhood. Just a warm shower followed by a few minutes of simple stretching.

Not sure what stretches to do? I always recommend the perfect combination of Yoga and Pilates style stretches to keep your back healthy and pain free.

So key things to remember –  If it’s just happened and very painful – Ice it!

If it’s stiff and tight – warm it up! 

For more tips like this on how to ease back pain, click here, where you can download your completely free guide with 9 easy ways to ease back pain.