Ice or heat? Heat or ice?That's probably the most common question asked about treating back pain.
The best way to answer it, I have found, is to explain exactly what ice and heat do and why they help relieve pain. Once you understand the mechanism behind these treatments, you'll be more likely to use them when your own back pain flares up.
The Pain-Spasm Cycle
Let's say you have sciatica. Your piriformis muscle goes into spasm. Your body reacts to this "injury" by sending more white blood cells to the injury site to fight the problem. That means fewer red blood cells go there, which means the injured area is getting less oxygen and nutrients, and waste products aren't being carried away. This causes what's called Secondary Hypoxic Injury. The site is actually injured even more by lack of oxygen (hypoxia).
It may also put the muscle into a pain-spasm cycle. The injury triggers nerves to send signals to the brain, which interprets it as pain. This pain tells the brain to send a signal back to the injured area, which contracts the muscles to close off blood supply to prevent swelling. But this lack of blood supply actually leads to more pain, more swelling and more spasms.
To review: The initial spasm causes pain and swelling, which leads to more injury and further spasms. More pain, more spasms, more pain, more spasms—a vicious cycle. Without treatment, this cycle can last for years. The only way to begin healing the muscle is to break this cycle. That's where ice and heat come into play.