Is Heat Good For Back Pain?

Can Warming Muscles Really Heal Them...

The Short Answer – Heat (or ‘thermotherapy’ to use it’s technical name) is regularly recommended for treating back pain.

In certain circumstances heat has been considered the number one treatment for back pain. Is heat good for back pain? Without a doubt – but not always.

We look at why heat works, when it works and how best to use it…

Is Heat Good For Back Pain?

In the old days, doctors would casually recommend ‘rest and relaxation’ for all forms of basic ‘mechanical’ back pain.

Unless your back pain resulted from an impact injury or had other underlying symptoms, the advice would be to rest for a few days and only come back if it didn’t improve.

As medical knowledge improved this has changed to following an ‘easier schedule’, rather than complete rest. The reason for this was that a complete stop encouraging inflammation to expand, stiffness to set in and, in the longer term, muscle wastage to take place.

The new advice to reduce your activities from heavy lifting and a large workload, but remain flexible and active. This has been found to decrease recovery times considerably.

As part of this, it is very likely you will be asked to use heat therapy to help you remain active throughout your rehab.

Indeed, many orthopaedic consultants and pain specialists will now recommend heat as a front line treatment for back pain.

But not all types of back pain.

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When Is Heat Good For Back Pain?

Heat is great for muscular back pain because it soothes the muscles and increases blood flow around the affected area.

It is perfect for muscular strains and pulls. Sometimes your clinician will recommend ‘hot and cold therapy’ (in other words with the addition of ice), but that is still up for debate.

The theory behind using cold therapy, is that is it great for reducing inflammation. But I cover this much more fully HERE.

The are 5 basic advantages that explain why heat is good for back pain –

  1. Heat dilates blood vessels in muscles that increasing blood flow which in turn delivers extra oxygen/ nutrients, helping to heal injured tissue.
  2. Heat helps to soften stiff muscles and tissue, increasing flexibility and comfort.
  3. Heat turns on sensory receptors in the skin. Through a concept known as ‘gate theory’, these block some of the pain signals from transmitting to your brain. In this sense, heat therapy can actually reduce pain.
  4. Heat is a relatively inexpensive therapy compared to most other treatments
  5. Heat therapy is convenient since it can be applied almost anywhere – most commonly in your own lounge room.

When Is Heat Not Useful For Back Pain?

Heat’s impact on your back pain relies on it’s ability to increase the blood flowing to your aching, painful muscles, treating both stiffness and helping with healing.

However, a few back injuries are much more than just a muscle strain. Fractures or herniated disks for example are much less likely to be helped by thermotherapy (heat).

In these cases, cold therapy (or cryotherapy) is potentially more appropriate as it can work on the inflammation. However, the ultimate treatment may well require surgery first.

In the case of arthritis, heat can be helpful for reducing the stiffness, but is likely to be more effective if combined with cold therapy (cryotherapy) as well.

The Proof That Heat Is Beneficial For Back Pain.

Heat has been accepted for so long as being beneficial, that very few studies have actually looked specifically at its effect.

One particularly relevant study by Mayer at al in Physical Medicine and Rehabilitation covered two randomized trials with 67 people using a low level heat wrap.

It concluded with…

“continuous low-level heat wrap therapy was of significant benefit in the prevention and early phase treatment of low back DOMS”
(DOMS stands for ‘delayed onset muscle soreness’)

Another very recent study (2019) in the Scandinavian Journal of Pain found that heat/ cold therapies were together voted number one in the list of effective treatments for helping with lower back pain. 

Of course, all of this does rely on successful use of heat therapy and not all heat related treatments perform the same.

The Final Word –

Clearly thermotherapy (heat) has a well established and high place when it comes to treating back pain.

It’s benefit’s originate from the ability of heat to dilate blood vessels, allowing faster oxygen-rich blood to reach the affected muscles – as well as offering greater mobility.

In 2020, much of the reliance for treatment of short-term muscle strain-induced ‘mechanical’ back pain (by far the most popular), lies with treatment at home.

And there are few more effective methods for treating short-term back pain at home than heat therapy.

Is heat good for back pain?

Absolutely yes.

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References Used –

1. Mayer JM, Mooney V, Matheson LN, Erasala GN, Verna JL, Udermann BE, Leggett S. (Oct 2006). Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Physical Medicine and Rehabilitation.
2. Jenny Setchell, Nathalia Costa, Manuela Ferreira and Paul W. Hodges. (April 2019). What decreases low back pain? A qualitative study of patient perspectives. Scandinavian Journal Of Pain.

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