Back pain! Heat or Ice?

[Eugene Choi]

My lower left side of my back is hurting a lot. It hurts to just walk, should i ice it or put a heating pad over it after and before stretching it??

[3fees]

Ice first-then heat--is the usual.

[mikeler]

I have better luck not using ice on my back.

[SoBad]

Heat on the outside and ice on the inside.

[charliefedererer]

Most areas respond best to ice in the first few days to try and decrease the inflammation.

Additionally, and importantly, nerve conduction works best at 98.6 degrees. So cooing an area interferes with pain sensors conducting pain.
Ice really is a cheap way of anesthetizing an area.



But the back is an usually an exception to the general guide that cold is the best initial therapy.



The muscles that are in spasm are usually not the superficial muscles of the back, but the deep ones, buried under several layers of muscle.

It is difficult to get these deep layers cold enough to really affect the pain. They are just too deep.



Also the mechanism of what is going on for most people with low back pain is different than pain in other areas.

Low back pain usually involves muscle spasm, while pain in most areas (fingers, elbows, shoulders, knees) does not involve muscle spasm.
Heat causes relaxation of muscle fibers leading to relief of the spasm.
(Conversely, cold causes contraction of muscle fibers, hence no relief of spasm and therefore no pain relief.)


The above is the reasoning behind why most sources recommend heat for low back pain.
The Claim: Heat Wraps Ease Back Pain http://www.nytimes.com/2007/05/01/he...real.html?_r=0

Notice that the above New York Times article that exercise is recommended after several days and worst pain and spasm has gone away.

Suzanna McGee, who posts here as Sixftlion has a a great tennis fitness site, Tennis Fitness Training.
She has an exercise, "cats and dogs", that seems deceptively simple, but is a good early exercise to flex and extend the back muscles:
"Cats & Dogs Exercise Helps Painful Shoulders, Elbows, Wrists, Lower Back and Knees": http://www.examiner.com/article/pain...-cats-can-help


Over the long term, a stronger core, which includes the back, can help prevent recurrences of low back pain.

While we play tennis for fitness, the serve and big forehands leads to muscle imbalances, and that includes putting undo stress on one side of the back more than the other.

So starting a back conditioning program with at least body weight squats and lunges would be recommended.


[Obviously, not all low back pain is due to muscle spasm. If your back pain is continuing to bother you, you should get checked out medically to see if there is some structural problem like a bulging disc.]

[Eugene Choi]

Thanks charlie helped me a lot. I went to my high school trainer and told her about it and how pain went down to my left thigh and she said it could be something called hernia on my disk or somethig like that. But ill check out those websites asap and start rehabilitation i guess you would call it.

[SystemicAnomaly]

CF is absolutely right about ice. Whereas ice is usually the first plan of attack for injuries/pain for most joints and muscles, the back is another matter. Ice is rarely suggested/prescribed for the back, particularly the lower back.

[ramosxp]

Originally Posted by SystemicAnomaly

CF is absolutely right about ice. Whereas ice is usually the first plan of attack for injuries/pain for most joints and muscles, the back is another matter. Ice is rarely suggested/prescribed for the back, particularly the lower back.

I agree, for me heat usually does it, particularly for the lower back. Also what I've been told and I tend to agree with is when my back is sore, I rest it for days sometimes a week, this actually made it worse at times. My back loosens up and feels better when I actually do light exercise every few days. I don't think sitting around and resting it too much helps like if you have sore knees.

[charliefedererer]

Originally Posted by Eugene Choi

Thanks charlie helped me a lot. I went to my high school trainer and told her about it and how pain went down to my left thigh and she said it could be something called hernia on my disk or somethig like that. But ill check out those websites asap and start rehabilitation i guess you would call it.

If the pain is radiating down your left thigh then this type of pain is called sciatica:

"Sciatica is a common type of pain affecting the sciatic nerve, a large nerve extending from the lower back down the back of each leg.

What Are the Symptoms of Sciatica?

Common symptoms of sciatica include:

Pain in the rear or leg that is worse when sitting
Burning or tingling down the leg
Weakness, numbness, or difficulty moving the leg or foot
A constant pain on one side of the rear
A shooting pain that makes it difficult to stand up
Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes.

For some people, the pain from sciatica can be severe and debilitating. For others, the sciatica pain might be infrequent and irritating, but has the potential to get worse."
- http://www.webmd.com/back-pain/guide/sciatica-symptoms


The sciatic nerve originates from many small nerve roots that exit the spinal column in the lower back.
The sciatic nerve then travels down the back of the buttocks to the back of the top of the leg, and then down through the center of the leg as the main nerve in the leg.




You mention one of the possible causes for this kind of pain - a hernited disc.

But there are other causes.


This is definitely something I would not fool around with.

I would make an appointment with your doctor as soon as possible to get checked out and see what really is going on.

This is not something that firm advice can be given about on-line. You should have a doctor advising you.

[Eugene Choi]

So if i feel better i have a duel this saturday, should i play or not?? Also tnxs about the sciathia facts ill keep it in mind

[*Val*]

Originally Posted by SystemicAnomaly

CF is absolutely right about ice. Whereas ice is usually the first plan of attack for injuries/pain for most joints and muscles, the back is another matter. Ice is rarely suggested/prescribed for the back, particularly the lower back.

Really? I've had a herniated disc (lower back) for over 3 years and always used ice

[charliefedererer]

Originally Posted by *Val*

Really? I've had a herniated disc (lower back) for over 3 years and always used ice

I'm interested to know if you think the ice really helped.

[charliefedererer]

Originally Posted by Eugene Choi

So if i feel better i have a duel this saturday, should i play or not?? Also tnxs about the sciathia facts ill keep it in mind

Sciatica - pain going down the leg - suggests a nerve is being compressed.

You don't want to worsen the problem and let that nerve get so compressed that weakness results.

Therefore, I think you should first get checked out medically.

What does your high school trainer say? Have you been back to see him and get more advice?

[*Val*]

Originally Posted by charliefedererer

I'm interested to know if you think the ice really helped.

Absolutely, for the first few months after injury I was icing multiple times a day, and I still keep ice packs in the freezer at the ready in case I need them. I can't imagine putting heat on my back. Both a chiropractor and physio told me ice, not heat. I always thought this was because it helps reduce inflammation. But I guess heat is good for like tight muslces/muscle spasms? I never really felt like I got spams, just sore back and ice always seemed to help soothe it

[SystemicAnomaly]

If there is inflammation present, then ice may very well be prescribed. It's been my understanding that most lower back pain does not involve inflammation and therefore does not require ice. If your experts are telling you to ice it, then it very well be warranted in your case. In general, tho', heat is usually prescribed for back pain from what I've been told and from what I've read.

[Kevin T]

Put me down in the ice camp. I have a long history of L4-5 herniation/extrusion due to sports injuries. Heat helps a little but ice packs really help. A fantastic, very progressive PT here in Cali recommended ice and it's worked out great. He would run me through a very strenuous core workout, then ice me for 10-15 minutes and recommended ice a few times per day during flare-ups. It worked better than heating pads, hot tubs, etc.

[SystemicAnomaly]

It look like we've heard from a couple of exceptions to the "heat only" rule (no ice) for back pain. Lest you think that these are not exceptions, check out the following sources:

(Almost) Never Use Ice on Low Back Pain!

http://www.WebMD.com/back-pain/tc/use-heat-or-ice-to-relieve-low-back-pain-topic-overview

[dlam]

Originally Posted by Eugene Choi

So if i feel better i have a duel this saturday, should i play or not?? Also tnxs about the sciathia facts ill keep it in mind

Listen to your body and rest if you can
I developed scatica down my right leg and still tried to play my twice a week games.
I couldn't sit without pain, I limped and had this numbness down my right leg, I went for physio for a year but still played and never got better,
Long story short I had to stop playing tennis and it got better, but I started to lose interest as I couldn't go all out and now 10 years later I back but playing weekly now
Played three matches this year and felt a bit of tightness,
The thing I have to watch out is my serve, I arch my back and twist too much.
I developed a pinpoint rather than a platform footwork, as I feel I have better stability for my spine.
Next I make sure lower body moves into the court, my feet have to leave the ground so there is no resistance in the lower back when I swing my arms.
In my pinpoint stance, I either move my right foot in front of my left foot, or I move my left foot baCk to my rig foot, and hop into the court with my upper arm serve motion
This puts zero strain on my back.