Hi this is dr. John Shim and today I want to talk about a very common and
controversial topic, and that's the use of ice versus heat for back pain.
We all know that for acute injuries such as sprained ankles or twisted knees
using ice is the preferred method it decreases inflammation decreases the
pain and in contrast in these acute horrible sprains and strains and even
breaks if you use heat you actually increase the inflammation may actually
cause more pain and discomfort. Well does that apply to your back? Well, it turns
out it's relatively controversial but in my opinion if you think you really
pulled or stretch the muscle or tendon or ligament of your back and it's really
very very painful I do think ice is a benefit to you. Ice
has that property of cooling the skin therefore cooling some of the nerves. Ice
also has that property of decreasing the inflammation so it could be beneficial
for you, but there are some cautions to must take when we use ice. Never put ice
directly on the skin because it could potentially cause frostbite. Always
use something like a towel barrier and do not apply it on the skin for more
than 10 or 20 minutes at a time. You can't repeat it as often as you like
after you give some recovery time to your skin. When you use ice make sure you
rest during that period of icing. I can't tell you how many times I see
people walking around with ice packs or doing work with ice packs still pushing
stretching pulling on their muscles. In a way you're kind of defeating the purpose
of using the ice because the ice are there to decrease the inflammation
swelling. If you keep pulling and tugging you're actually flaring up the situation.
Get some rest during the period of using ice. Ice packs can be gel packs frozen
towels or even a package of frozen peas. Folks with certain medical conditions
such as Raynaud's disease, loss of sensation to the area, or paralysis
should avoid ice therapy. Studies have shown ice can be beneficial but more
studies need to be done.
Now I want to switch gears and talk about the use of heat. It turns out heat
therapy can be beneficial for chronic back pain and stiffness but not for
acute injury. Remember that as I talked before in acute injuries you can
actually increase the swelling and inflammation. In chronic conditions
chronic stiffness heat can help dilate the blood vessels and deliver more nutrients
to the sore and stiff area. Heat helps stretch the softer tissues
including the muscles, ligaments, tendons and it eases stiffness. Forms of heat
include a hot water bottle use of a sauna or a warm bath. For those with loss
of sensation or paralysis you have to use caution because it can be too hot or
you won't feel how hot that area would be. Remember not to apply a hot water
bottle for more than 20 minutes at a time and use some common sense and don't
stay in a Sode up for more than 15 to 20 minutes. Always check your water
temperatures both with the water bottle and before getting into the bathtub.
Studies have shown some limited benefit to heat therapy and more studies need to
be done to prove its benefit. An alternative treatment is to rotate cold
and heat therapy every 15 to 20 minutes for chronic conditions but remember the
general principle, avoid heat for acute injuries use heat for chronic stiffness
and chronic arthritis type conditions. This is Dr. Shim talking about the use
of heat versus cold and treating back pain. Thank you for listening.