Can applying heat or cold help lower back pain?

When your back hurts, it can be hard to figure out whether to use cold or heat for relief. Physical therapist Peggy Brill gives her recommendation.

Transcript

00:00

People used to think that you only use cold in the first 48 hours of a problem. That no longer is true.

00:06

[MUSIC PLAYING]

00:13

I'm glad that I'm being asked this question because I'm asked this all the time. When do I use hot? When do I use cold? People used to think that you only use cold in the first 48

00:21

hours of a problem. That no longer is true. We understand so much more today about inflammation from a systemic and from a mechanical viewpoint

00:30

of what's creating the tissues to inflame. I would say, nine out of 10 times, I'm going to tell you to ice. Now, sometimes I have people come in

00:37

and they have Raynaud's or they're frail and they're not going to respond well to cold. It's just going to tighten them up. I will use heat over cold.

00:45

A lot of times what I like to do is a combination. If I had an ideal situation, I would just say use cold, then hot, use hot, then cold.

00:52

Alternate, so that you create a flushing through the body and get vasoconstriction and dilation. That's what helps promote the healing.

00:59

If cold is like oh, my God, it's winter, I don't want to put cold on my back-- you don't have to lie down necessarily for it. A lot of times I'll tell people, get a hot pack.

01:07

All right? Sit down. You're having dinner. You're reading the paper. You're on the computer. Put the cold pack in your low back,

01:14

covered, inside a pillowcase, for 10-15 minutes. Take a heating pad and put it around your neck. So you have the soothing effect of being warm-- like,

01:23

if you're on a tropical island, everybody feels good with the warmth of the sun-- you get that relaxing feeling in your body that helps the tissues to relax

01:30

in your spine and you get the anti-inflammatory and the anti-spasm along your low back. [MUSIC PLAYING]