Which is Better for Back Pain, Ice or Heat?

This comes up all the time in my clinic, AND probably about half the people with acute pain make the WRONG CHOICE!

So, if you have any significant increase in pain, inflammation (swelling) is always involved.  Here is the confusing part: if you heat a joint or tissue that is swollen IT FEELS GOOD while you heat it.  BUT, heat will cause more swelling and that leads to an increase in pain in the next few hours (even if the pain does not increase, using heat will definitely perpetuate the swelling and pain).

For acute pain, bring the swelling down naturally with ICE.  The rule for ice is 20 minutes on then remove.  You can ice as many times as you like as long as you wait one hour between icing.

PS - Heat is okay when you are just a little stiff/achy.

Any questions are welcome...