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Month: November 2016

Ice Packs

Simple application of a cold pack or ice placed in a plastic bag and wrapped in a towel or other protective barrier (to protect the skin from ice burn) is one of the most effective pain relief treatments available.

Ice or a cold pack should be applied for no more than 20 minutes at a time and can be applied several times a day (e.g. up to eight or ten times in a twenty-four hour period).

Types of Ice Packs and Cold Packs

There are many types of ice packs that can be used for relief of lower back pain. All of the options are effective, and patients can select which works best for them based on personal preference, budget, and convenience.

Common types of cold packs that are effective for lower back pain include:

Reusable Cold Pack or Ice Pack
Many types of reusable ice packs (such as those filled with gel) are available at drug stores, general merchandise stores, and our office! These cold packs can be kept in the freezer ready for use when needed, and re-frozen after each use. For an inexpensive alternative, reusable cold packs can be made at home.

Homemade Ice Pack
To make an ice pack, simply put the desired amount of ice in a plastic bag (baggie) and squeeze the air out of the bag before sealing it. Some people like to add a little water to the ice so that the bag is not so lumpy. The bag should be wrapped in a towel before applying it to the painful area to protect the skin from ice burn. Additional alternatives include:

    • A frozen towel. To make a towel into a cold pack, place a folded, damp towel in a plastic bag and put it in the freezer for ten to twenty minutes. Then take the towel out of the bag and place it on the affected area.
    • Sponge. Wet a sponge and put in the freezer. After it is frozen, take it out and put it in a baggie, then wrap it in a sock or a towel before applying it to the sore back.
    • Rice. Another alternative is to fill a sock with rice and place it in the freezer, as rice will get as cold as ice but does not melt when used.
    • Gel-type pack. Still another alternative is to fill a baggie with liquid dishwasher detergent and freeze it, which gives it a consistency of a gel pack.
    • Frozen bag of peas. If ice is needed quickly, it is easy to grab a bag of frozen peas or other vegetables out of the freezer, wrap it in a towel and apply it to the painful area.

Disposable Ice Packs/ Instant Ice Packs
Single use cold packs have the advantage of becoming cold almost instantly through a chemical reaction that takes place once the pack is “cracked”. Because they are ready at any time, prior planning in terms of putting the ice pack in the freezer is not needed. Another advantage is that the chemical reaction in the pack allows it to stay cold for an extended period of time while being used at room temperature. The main disadvantage of instant ice packs is that they can only be used once, making them more expensive than reusable ice packs or homemade ice packs. A variety of disposable, instant ice packs are available at most drug stores and general merchandise stores.

Ice Application Precautions

To avoid getting an ice pack burn, be sure to limit application of ice to no more than twenty minutes and do not fall asleep lying on an ice pack.

As with all pain relief treatments, there are some cautions with applying ice and using ice therapy.

  • Never apply ice directly to the skin. Instead, be sure that there is a protective barrier between the ice and skin, such as a towel.
  • Limit the ice application to no more than fifteen or twenty minutes at a time.
  • Ice application should be avoided by patients with certain medical conditions, such as for patients who have rheumatoid arthritis, Raynaud’s Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation.

Ice massage and ice application is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process.

For some people, alternating heat therapy with cold application provides the most pain relief.

Ice Massage

To do ice massage therapy, a regular ice cube may be used, but it’s better to use a larger piece of ice. One easy way to do this is to freeze water in a paper or Styrofoam cup, then peel the top inch or two of the cup to expose the ice surface.

Someone else can give the ice massage, with the patient lying on his or her stomach in a comfortable position. Placing a pillow or towel under the hips will help keep stress off the low back. Patients can also give themselves ice massages by lying on their side and reaching around to apply ice to the low back.

5 Steps of Ice Massage Therapy

For optimal results, ice massage therapy should be gently applied to the lower back as follows:

  1. Apply the ice gently and massage in a circular motion
  2. Focus the ice massage therapy on the six-inch area of the back where the pain is felt
  3. Avoid applying the ice massage directly on the bony portion of the spine (the bones that protrude along the spinal column)
  4. Limit the ice massage therapy to about 5 minutes at a time (to avoid an ice burn)
  5. Repeat the ice massage two to five times a day.

In general, one should never apply ice directly to the skin to avoid burning the skin. However, with ice massage therapy it is acceptable to apply the ice to the skin because the ice doesn’t stay in one place for long.

The key to ice massage therapy is to achieve numbness in the area of injury without burning the skin. Once this ‘numbness’ has been achieved, gentle, minimal stress movements can be made. When the numbness has worn off, the ice massage can be applied again for another cycle.

Ice massage and ice application is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application/icing provides the most pain relief.

Ice Massage Precautions

To avoid getting an ice burn, there are several precautions to take with ice therapy:

  • When applying ice directly to the skin on the back, be sure to keep the ice moving in a slow, circular motion to avoid staying in one place too long.
  • Limit the ice massage to no more than five minutes at a time.
  • Be sure not to fall asleep with the ice resting on the skin.
  • Ice application of any kind should be avoided by patients with certain medical conditions, such as for patients who have rheumatoid arthritis, Raynaud’s Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation.

One does not have to include massage with the ice to benefit – simple application or an ice pack or cold pack to the painful area is also an effective pain reliever.

How to Apply Heat Therapy

The most effective heat therapy products are the ones that can maintain their heat at the proper temperature. “Warm” is the proper temperature. Patients should not have their heat source be hot to the point of burning the skin. The desired effect is for the heat to penetrate down into the muscles. Simply increasing the temperature of the skin will do little to decrease discomfort.

In many instances, the longer the heat is applied, the better. The duration that one needs to apply the heat, though, is based on the type of and/or magnitude of the injury. For very minor back tension, short amounts of heat therapy may be sufficient (such as 15 to 20 minutes). For more intense injuries, longer sessions of heat may be more beneficial (such as 30 minutes to 2 hours, or more).

Types of Heat Therapy

Two options for heat therapy include moist heat and dry heat.

  • Dry heat, such as electric heating pads and saunas, draw out moisture from the body and may leave the skin dehydrated. However, some people feel that dry heat is the easiest to apply and feels the best.
  • Moist heat, such as hot baths, steamed towels or moist heating packs can aid in the heat’s penetration into the muscles, and some people feel that moist heat provides better pain relief.

A specific type of heat therapy may feel better for one person than for another, and it may require some experimentation to figure out which one works best. There are many different manners for heat to be applied to the lower back. Some common options include:

  • Hot water bottle – tends to stay warm for 20 to 30 minutes.
  • Electric heating pad – maintains a constant level of heat as long as it is plugged in.
  • Heated gel packs – may be microwaved, or sometimes heated in water, and tend to say warm for about 30 minutes. Certain types of gel packs provide moist heat, which some people prefer.
  • Heat wraps – wraps around the lower back and waist and may be worn against the skin under clothing, providing convenience and several hours of low level of heat application.
  • Hot bath, hot tub, sauna, steam bath – tend to stimulate general feelings of comfort and relaxation that may help reduce muscle spasm and pain. A whirlpool jet directed at the lower back may provide the added benefit of a light massage.

Finally, it is important to use enough insulation between the heat source and the skin to avoid overheating or burning the skin.

When Heat Therapy Is Not an Option

Please note that heat should not be used in certain circumstances. For example, if the lower back is swollen or bruised, heat should not be used. Patients should consult doctors if they have heart disease or hypertension. Heat application is also not suitable in the following cases:

  • Dermatitis
  • Deep vein thrombosis
  • Diabetes
  • Peripheral vascular disease
  • Open wound
  • Severe cognitive impairment

In general, if the injured area is swollen or bruised it is better to apply ice or a cold pack to reduce the swelling.

In summary, heat therapy is an easy and inexpensive option to provide relief from many forms of lower back pain. It may be used alone or in conjunction with other therapies. Because it is so simple, it is often overlooked and physicians may forget to mention it, but heat therapy used in the right way can be a valuable part of many lower back pain treatment programs.

Heat Therapy

While the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.

In addition, heat therapy for lower back pain – in the form of heating pads, heat wraps, hot baths, warm gel packs, etc. – is both inexpensive and easy to do.

How Heat Therapy Works

Many episodes of lower back muscle strain result from strains and over-exertions, creating tension in the muscles and soft tissues around the lower spine. As a result, this restricts proper circulation and sends pain signals to the brain.

Muscle spasm in the lower back can create sensations that may range from mild discomfort to excruciating lower back pain. Heat therapy can help relieve pain from the muscle spasm and related tightness in the lower back, AFTER any swelling has gone down.

Heat therapy application can help provide lower back pain relief through several mechanisms:

  • Heat therapy dilates the blood vessels of the muscles surrounding the lumbar spine. This process increases the flow of oxygen and nutrients to the muscles, helping to heal the damaged tissue.
  • Heat stimulates the sensory receptors in the skin, which means that applying heat to the lower back will decrease transmissions of pain signals to the brain and partially relieve the discomfort.
  • Heat application facilitates stretching the soft tissues around the spine, including muscles, connective tissue, and adhesions. Consequently, with heat therapy, there will be a decrease in stiffness as well as injury, with an increase in flexibility and overall feeling of comfort. Flexibility is very important for a healthy back.

There are several other significant benefits of heat therapy that make it so appealing. Compared to most therapies, heat therapy is quite inexpensive (and in many circumstances, it’s free – such as taking a hot bath). Heat therapy is also easy to do – it can be done at home while relaxing, and portable heat wraps also make it an option while at work or in the car.

For many people, heat therapy works best when combined with other treatment modalities, such as physical therapy and exercise. Relative to most medical treatments available, heat therapy is appealing to many people because it is a non-invasive and non-pharmaceutical form of lower back pain relief.