When Should I Use Heat Versus Ice For Neck or Back Pain

When Should I Use Heat Versus Ice For Neck Or Back Pain

If you’ve ever had a sore or strained muscle in your neck or back, chances are someone’s told you to put heat or ice on it, or perhaps both.

This has become quite a common home remedy for muscular pain but you might be doing it wrong.

How should you use heat or ice for pain?

Basically, you should apply ice to the muscular injury for the first 48 hours, followed by heat. This is because the ice will relieve swelling and inflammation and then the heat will loosen up the muscles so that they can heal.

That said, some pain only requires a cold compress, while others will need to be treated with heat. Here’s how to know when to do what to get the best pain relief.

Ice Is For Injuries

Holding Ice On Knee

The general rule is that if your neck or back pain is as a result of injury, you need to put ice on it as soon as you can.

The pain is probably causing symptoms like swelling, and that’s because the tissues have been inflamed.

So, you want to cool everything down. Icing an injury is sometimes also used as part of the RICE treatment strategy.

What Is RICE?

RICE stands for Rest, Ice, Compression, and Elevation.

It basically means that when you hurt yourself, such as when you sprain your ankle, you want to rest, put some ice on it, wrap it up, and keep your ankle elevated.

RICE is a method that’s used for minor injuries, such as sprains and strains, and it helps to reduce pain and swelling.

How You Should Apply Ice

When applying ice to an injury, you want to avoid causing damage to your skin.

First things first, never apply ice directly to your skin as this can cause redness and even frostbite if you do it for too long.

The best way to apply ice is to grab a bag of frozen peas or ice pack and wrap it in a light towel. Then apply this to the site of the injury.

You should only leave it on your skin for about 15 minutes, every two to three hours, during the first day or two of your injury.

The cold will numb the pain and constrict blood vessels to bring down the swelling in the area.

Ice Treatments: When They Work

We mentioned earlier that ice packs can be used to alleviate minor injuries, but ice treatments are also useful for chronic conditions.

An example is when athletes overuse their muscles. Applying ice to the area can help to decrease inflammation.

Warnings When Applying Ice To The Skin

Along with the importance of not applying ice to your skin for longer than is considered safe so as to prevent damage, there are some special precautions you should follow.

  • Avoid using ice therapy if you have a heart condition unless your doctor gives you the go-ahead.
  • If you’ve applied ice packs to your injury but it hasn’t alleviated the pain and swelling within two days, make an appointment with your doctor.
  • Don’t use ice to treat stiffness, such as a stiff neck, as that can actually make it worse. This is because ice constricts the blood vessels, and that’s the last thing you want to do if you’re suffering from stiffness. You want to increase neck flexibility by boosting blood circulation, which is where heat treatments can prove beneficial.

Heat Is For Sore Muscles And Chronic Conditions

Using Heating Pad

The use of heat, such as with a hot towel or heating pad, can help to relax the muscles.

Heat stimulates blood flow to the affected area, so it brings more oxygen and nutrients to the muscles in order to help them heal.

Heat is ideal for chronic conditions and it can even warm up muscles before activity, such as in the case of an athlete applying heat to an injury associated with overuse, as the Southern California Orthopedic Institute reports.

Two Types Of Heat Treatment

There are two ways in which you can administer heat to sore, stiff muscles in your back or neck.

  • Dry heat – this is otherwise known as conducted heat therapy and it refers to heating pads, saunas, and dry heating pads.
  • Moist heat – this is otherwise known as convection heat and it refers to heat treatments such as hot baths and steamed towels. A study published in the Journal of Clinical Medicine Research found that moist heat is a bit more effective than dry heat and can be applied with better results in a shorter amount of time.

How long should you apply heat?

While you should limit the amount of time in which you apply cold to your body, you can indulge in heat treatment for longer.

Minor pain and stiffness can benefit from about 15 minutes of heat therapy, while more intense pain should be treated with longer heat therapy sessions, with anything from 30 minutes to two hours being recommended, as Healthline reports.

Using Heat For Stiff Muscles

Earlier, we touched on how you should avoid applying ice to a stiff muscle as that can cause it to tighten up more.

The best remedy for stiff muscles is to use heat therapy. That’s because heat therapy loosens the stiff muscles and tendons that are under attack.

Warnings When Using Heat Therapy

Although heat therapy offers many benefits when treating pain, it also has some important information you should consider before proceeding with it.

  • You should never use heat on muscles that have been injured as this can actually cause swelling to get worse!
  • Always make sure the heat you’re using is warm instead of hot as that can burn your skin.
  • If you’ve used heat therapy on your sore neck or back and it hasn’t made your pain better after a week, you should consult with your doctor as you might require medication to treat the pain.

So, When Should You Alternate Putting Ice And Heat On Your Muscles?

Back Pain

Sometimes, you might find that using ice on an injury can be beneficial but it’s not going to help you for long.

You need to apply some heat to the injury to help you heal. But when should you do this?

If the cause of your pain is related to the stiffness.

If you’re experiencing lower back pain, the application of ice can work to give you relief from the pain.

But, if you’re also battling stiffness in this area, applying heat will help to loosen those nasty muscle spasms and help the area to heal by bringing more blood to the area.

Another situation in which you should apply ice followed by heat is in the case of sciatica. This pain starts in the back and then moves down the legs.

The reason why you should start with ice followed by heat is that the symptoms are neurological in nature and since they originate closer to the spine, ice should be the first method of treatment, as The Healthy reports.

It’s clear that sometimes ice isn’t enough to alleviate pain while other times heat on its own isn’t effective.

Therefore, the use of heat or cold for lower back pain used in succession can help to heal the muscles and relieve pain associated with certain conditions.

Related Questions

Can cold weather cause muscle pain?

Cold temperatures can cause muscles to feel painful and this is because the cold tightens the ligaments, tendons, and muscles that support the spine.

Therefore, if your body is already cold, avoid applying cold therapy as this can make them tighten up even more.

Can applying heat and ice on muscles be more effective than painkillers?

In some cases, heat and ice can be more effective than drugs. The research reported by Reuters found that after surgery, patients who applied ice to their pain required less medication.

One of the biggest benefits of using heat and ice is that you don’t have to worry about the side effects of medication.


It’s not always easy to know when you should apply ice or heat to sore muscles in your back or neck.

By following the advice in this article, you’ll be able to remember which one works best in the future, like when you’re experiencing muscle spasms or wake up with a sore neck.

But remember, if ice or heat treatments don’t help to reduce your pain, you should consult with a doctor who’ll be able to help you discover the source of your pain and eliminate discomfort with the right treatment plan.

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