Should I use Heat or Ice?

Back & Neck Pain

May 29

So you've hurt your back and you want relief fast - what do you reach for ice or heat? This is an age old question and the answer is starting to change. Dr. Robin Armstrong, your chiropractor at Willowbrook Chiropractic in Langley, discusses which is better: heat or ice when you have a new injury.

For many years, ice was our go to treatment for a soft tissue injury like a sprain or a new back injury. Ice is great at numbing the pain and bringing down inflammation. But now through our study of anti-inflammatory medication and its effect on recovery, the advice now is not to interfere with the natural recovery process of our body, which involves some natural inflammation. In fact heat can help increase blood flow to the area and calm the irritated muscles. Learn the new approach to injuries “PEACE & LOVE”.

In this video, Dr. Robin discusses:

The benefits of ice
The benefits of heat
The new thinking around controlling inflammation when we injure ourselves
Learning the new approach to injuries “PEACE & LOVE” which replaces “RICE”

The thinking on the use of heat and ice has evolved so please feel free to ask Dr. Robin Armstrong or Dr. Jody Freedman if you have any questions, we are always happy to help.

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Full Blog/Transcript:

First, let's understand what each does. Ice is excellent at pain relief and numbing the area, either by numbing the nerve endings or suppressing and bringing down the inflammation. Heat is good at relaxing spasming muscles. It helps tight, stiff joints get moving a little better and can be quite soothing.

When you injure yourself, inflammation is a natural part of the healing process and can be a good thing because it sets your body up for the next stages of recovery. We now know that for soft tissue injuries or back injuries, we want to avoid anti-inflammatory medication. There's no evidence that it helps, and some evidence suggests it can slow down recovery. If you're reaching for medication, you should opt for pain-relieving medication instead of anti-inflammatory.

Heat on the other hand was often not suggested during this acute stage of an injury because it does increase blood flow to an area and could increase inflammation. But when it comes to the back, heat can be really helpful for stopping muscle spasms and improving our ability to move.

Whereas the old advice for a soft tissue injury was RICE - rest, ice, compress, elevate. There is new advice with the acronym PEACE & LOVE which goes beyond those first 24 hours of an injury. Now we want to:

Protect
Elevate
Avoid anti-inflammatory medication
Compress an injury like an ankle sprain or wrist injury to help with swelling
Educate ourselves about the natural healing process

Load slowly as we return to regular activities
Optimism about our body's ability to recover
Vascularization through general cardiovascular exercise
Exercise by gradually restoring mobility and strength - no more bed rest for back pain, we want active recovery.

Although ice has been recommended for many years as conventional wisdom, there isn't good research showing it helps speed up recovery. My advice to patients is, if you find ice helpful for pain relief in the first 24 hours, use it in moderation, but consider switching to heat via a heating pad or a hot shower or bath. Heat calms muscle spasms and enables better movement, helping you to load, increase vascularization, and do specific exercises, thereby speeding up recovery.

We happen to sell a gel pack in our office at cost that can be both an ice pack in the freezer or heated up in the microwave to be a hot pack. So just ask our front desk if you are interested in purchasing one.

The thinking on the use of heat and ice has evolved so please feel free to ask Dr. Robin Armstrong or Dr. Jody Freedman if you have any questions.