Healthcare professionals often recommend heat or ice therapy to relieve back pain. Which type of therapy to use depends on the cause of the pain and a person’s individual circumstances.

Back pain affects 30–40% of adults, and it increases in prevalence in older populations. It can happen as a result of a medical condition, injury, or even just a part of the natural aging process.

Heat or ice therapy can be an effective treatment option for back pain. Cold treatment can reduce inflammation of the muscles, while heat treatment can promote the healing and relaxation of damaged muscles.

It is important for people to remember to never use extreme temperatures on bare skin.

Read on to learn how and when these treatments can be useful, along with other possible remedies for back pain.

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A person can apply ice, heat, or both, to help relieve back pain. A person can apply ice, or cold therapy, to help ease pain related to acute injuries or pain. Heat therapy can help ease muscle stiffness and pain.

According to a 2021 article, both hot and cold therapy can help alleviate pain. In addition to pain relief, cold therapy can help reduce bruising, inflammation, and swelling, and heat therapy can help relieve muscle spasms.

A person may wish to alternate between hot or cold therapy. Versus Arthritis, a U.K.-based nonprofit, notes that alternating between hot and cold therapy can help relieve back pain.


Before applying hot or cold therapy, people should consult a healthcare professional.

Hot or cold therapy may not be suitable if a person has:

  • heart conditions, such as angina
  • scar tissue
  • peripheral vascular disease
  • poor circulation
  • Raynaud’s disease
  • cold sensitivity
  • skin conditions, such as eczema or dermatitis
  • history of cancer
  • infection or high temperature

People with conditions that affect sensory detection, such as diabetic neuropathy, should avoid temperature therapies.

Cold therapy may be helpful in treating back pain related to injured muscles, such as strains and sprains. This is because cold therapy can help reduce bruising, swelling, and inflammation.

Rest, ice, compression, and elevation (RICE) are standard practices for sports injuries. This works by narrowing the blood vessels, preventing inflammation in the muscles.

How to apply cold therapy

To safely apply cold therapy to the back, a person should:

  1. Wrap the ice pack in a towel, as this can help protect the skin.
  2. Place the ice pack over the sore area and leave it for 10–15 minutes.
  3. Repeat every 2–3 hours, providing the temperature of the skin has returned to normal.

A person should never apply cold therapy for longer than 20 minutes at a time.

People can also perform an ice massage. This method can provide relief to an area measuring 10 centimeters (cm) by 15 cm.

To perform an ice massage, apply an ice cube to the skin in a slow circular motion for no longer than 10 minutes.

Ice should not be in direct contact with the skin. To avoid ice burn, a person should wet the ice cube under the tab and wrap it in a piece of kitchen towel.

Heat therapy can help ease acute and chronic back pain. A person should apply heat to their back to help relax the muscles, reducing pain.

Applying heat to the muscles can cause the blood vessels to dilate, improving circulation. This promotes the healing of any damaged muscle.

It also activates the nerve endings in the targeted area that is causing pain. This activation initiates a process that can block pain signals in the spinal cord.

Heat therapy can also be comforting. This may be a reason for its analgesic properties in managing back pain.

A 2021 research review notes that early treatment with heat therapy can help prevent mild lower back pain from progressing into chronic lower back pain.

For those with mild back pain, heat therapy can also help reduce the need for medications. For those with moderate to severe pain, heat therapy can reduce the strength of medication a person might need.

Authors of a 2020 study examined the effectiveness of heat on pain relief in those with chronic back pain.

They gave one group a heating device that applied pulsed heat at 45°C (113°F), and the other group a heating device that provided constant heat at 37ºC (97°F).

They found that the group with the high heat experienced significantly better pain relief that also lasted longer.

How to apply heat therapy

To safely apply heat therapy to the back, a person should ensure the hot water bottle or heat pack is wrapped in a few towels. Then, they can apply it to the sore back for 10–15 minutes.

A person can repeat this up to three times a day.

People can also:

  • take a warm bath or shower
  • use heat wraps
  • apply topical medications that contain substances such as capsaicin

A 2021 study indicates that moist heat, such as moist heat wraps, targets muscle pain faster and more effectively than dry heat wraps.

Heat wraps will vary depending on the individual instructions, so a person should always follow the given instructions.

People should ensure that they do not fall asleep while using heat therapy.

If a person experiences severe back pain, a person should contact a doctor immediately. Seeking help as soon as possible can help prevent further injury.

A healthcare professional may put a person in contact with a physical therapist or supply a prescription for medications.

If back pain symptoms are mild, heat and cold therapies can be effective methods of reducing pain and helping heal any muscle damage.

A person should be sure to not use extreme temperatures on bare skin, and they should consult with a doctor if their back pain persists or worsens.