Do you ever experience that nagging pain in your back after a demanding workday, an intense workout, or simply during your day-to-day routine? If so, you’re not the only one. Back pain is a widespread problem that can really disrupt your day, making even basic daily life activities like sitting and standing a challenge. Fortunately, remedies such as heat therapy, employed for generations in various forms, can help to relax your muscles and offer lasting back pain relief.1
This article will briefly explore the causes of back pain, focusing mainly on the different forms of heat therapy used for relief, along with their associated benefits and potential risks.
What is back pain and what causes it?
Back pain, especially lower back pain, ranks among the top reasons why people seek emergency medical attention. It may vary in intensity from a persistent discomfort in your back to an abrupt, piercing pain that might radiate along your leg.
Back pain can emerge suddenly due to an accident, or lifting something heavy, or may develop gradually due to age-related changes in the spine.2 Factors responsible for back pain may include:2,3
- Ligament injury or sprain
- Muscle injury or strain
- Structural problems in the back, such as scoliosis and stenosis
- Sciatica, a condition caused by the compression of the sciatic nerve that runs from the lower back to the feet
- Pregnancy
- Thinning and weakening of bones (osteoporosis)
Apart from these reasons, back pain may rarely be caused by serious conditions such as infections, tumours, and fractures.3
Heat therapy is frequently recommended by healthcare professionals as an effective method for alleviating the discomfort caused by back pain.
In fact, a research review based on several trials mentions that early treatment of lower back pain through heat therapy can prevent acute back pain from developing into chronic back pain while also enhancing muscular strength and flexibility.1
What is heat therapy and how does it help with back pain?
Heat therapy involves the application of warmth to a particular area of the body for healing injured muscles, tissues, or joints. This can be achieved using various forms of heat, such as heating pads, hot showers, and heated gel packs, depending on individual preference and availability.1
Heat therapy brings significant relief for back pain in the following ways.
Heat accelerates the healing of injured tissues
When heat is applied to the lower back, the temperature of the region increases, which dilates the blood vessels. Because of this, there is enhanced flow and circulation of blood to the back muscles.
Better circulation, in turn, facilitates increased and more efficient delivery of blood, oxygen, and important nutrients to the injured muscle tissue, helping in faster healing and relaxation of stiff joints.
Heat helps in soothing painful muscle spasms
Involuntary painful muscle contractions, called spasms, are often experienced in most types of lower back pain. These contractions restrict blood circulation, leading to the transmission of pain signals to the brain.
Applying heat to the lower back increases blood circulation, which helps relax tense muscles, alleviate tightness in the back, and reduce associated pain.
Heat therapy makes physical therapy sessions more bearable
For treating lower back pain, physical therapy involving back stretches and exercises is common. Doctors often advise using heat therapy on the back before these sessions because it:4
- Relaxes muscles, making them more responsive to therapy
- Reduces muscle stiffness makes exercises easier and less painful to perform
Heat blocks the transmission of painful stimuli to the brain
Applying heat triggers the sensory receptors of neurons in the skin and deeper tissues. The gate control theory states that a pain-gating mechanism in our spinal cord regulates the transmission of pain. In simple terms, spinal nerves function as gates, either allowing pain signals to travel to the brain or blocking these signals altogether.
In our body, nerve fibres with smaller diameters carry pain messages to the spinal cord and open these gates, allowing pain signals to reach the brain. Conversely, nerve fibres with larger diameters are activated by stimuli like warmth. This helps to close the gates, reducing the transmission of pain signals to the brain.
Heat therapy is a cost-effective alternative to pain medications
Heat therapy is a non-invasive and relatively inexpensive treatment option for back pain. It can be easily performed at home with simple devices such as heating pads or warm baths.
Moreover, it has a lower risk of side effects and reduces the likelihood of drug dependence that can be associated with frequent use of pain medications for back pain.
What are the different types of heat therapy for back pain?
Heat therapy is majorly classified into two types, which are:
Dry heat therapy
Dry heat therapy involves the application of direct heat on the affected area to reduce muscle stiffness and provide comfort. This may include using materials like:
- Heating pads (electric or in the form of hot water bottles) to deliver warmth to the affected area
- Heat wraps (adhesive patches or wraps that can be directly applied to the skin)
- Dry saunas (heated rooms or enclosures that use dry heat to induce sweating and promote relaxation)
- Heat lamps which emit infrared radiation to generate heat
Dry heat therapy options are usually more convenient to use and carry. They also have a longer lifespan compared to moist heat therapy options. However, they can cause tissue dehydration and do not penetrate heat deeply into the tissues, which limits their long-term effectiveness.5
Moist heat therapy
Moist heat therapy involves applying a wet source of heat on the affected area to increase blood flow, relax muscles, and reduce pain. Several forms of moist heat include:
- Warm compresses (towels or washcloths soaked in warm water and applied to the affected area)
- Hydrocollator packs (reusable packs filled with a special gel that retains heat when heated in water)
- Paraffin wax baths (devices that heat paraffin wax to a comfortable temperature, allowing for immersion therapy of hands, feet, or other body parts)
Moist heat therapy penetrates muscle tissues more effectively than dry heat therapy, providing longer-lasting relief. It's also regarded as safer when used at the appropriate temperature.5
Finding the type of heat therapy that works best for you may involve trying out different products and services. For example, if you have more than 25% body fat, moist heat could be a better option for soothing your back pain.
How to apply heat therapy for back pain
For effective heat therapy, it's important to maintain a warm, but not excessively hot, temperature. While some products may use higher temperatures, they are safe only when there is enough insulation between the heat source and your skin.
Typically, the longer you apply heat, the more your muscles relax. Applying heat for enough time allows the warmth to sink deep into your muscles.
The right duration varies depending on the severity of the injury. For minor back tension, 15 to 20 minutes should be sufficient, while chronic conditions or severe pain may benefit from up to 30 minutes of heat therapy.
Remember, it's never safe to sleep with a heating pad.
Are there any risks associated with heat therapy for back pain?
While heat therapy offers an effective solution for back pain treatment, it's important to acknowledge that, like any treatment, it carries potential risks and complications, especially if not used properly. Some of these include:
- Skin burns or rashes caused by extended use of hot packs or heating pads, or by applying excessive heat without a protective barrier
- Reduced blood pressure which may pose challenges for individuals prone to dizziness or lightheadedness upon standing
- Elevated heart rate due to the faster beating of your heart to accommodate increased blood flow, presenting risks for those with heart conditions
- Risk of inflammation, if used on open wounds or swollen areas
You must avoid using heat therapy immediately after physical activity, injury, or during an infection. Heat therapy may intensify pain and delay healing in injured or infected tissues.
Moreover, if you suffer from conditions, such as dermatitis, thrombosis, or diabetes, it's best to avoid heat therapy. If you are considering using heat therapy, consult your doctor for guidance on safer alternatives. People with cognitive impairments, such as those diagnosed with dementia, may also need a safer alternative to heat therapy or support to use it safely.
Summary
Heat therapy provides a gentle and comforting solution for easing the discomfort of back pain, much like a warm hug for your tired muscles. However, while it promises relief, it's essential to use heat therapy carefully and in consultation with a healthcare provider. By taking these precautions, you can maximise the therapy's benefits while minimising potential risks, allowing you to safely experience the full healing potential it offers.
References
- Freiwald J, Magni A, Fanlo-Mazas P, Paulino E, Sequeira de Medeiros L, Moretti B, et al. A role for superficial heat therapy in the management of non-specific, mild-to-moderate low back pain in current clinical practice: a narrative review. Life (Basel) [Internet]. 2021 Aug 2 [cited 2024 May 2];11(8):780. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/
- Ge, L., Pereira, M.J., Yap, C.W. et al. Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: a cross-sectional study in Singapore. Scientific Reports. 2022. [cited 3 September 2024]; 12, 20040. Available from: https://www.nature.com/articles/s41598-022-24703-7#citeas
- Nicol V, Verdaguer C, Daste C, Bisseriex H, Lapeyre É, Lefèvre-Colau MM, Rannou F, Rören A, Facione J, Nguyen C. Chronic Low Back Pain: A Narrative Review of Recent International Guidelines for Diagnosis and Conservative Treatment. Journal of Clinical Medicine. 2023. [cited 3 September 2024]; 12(4):1685. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964474/
- Petrofsky JS, Laymon M, Alshammari F, Khowailed IA, Lee H. Use of low level of continuous heat and Ibuprofen as an adjunct to physical therapy improves pain relief, range of motion and the compliance for home exercise in patients with nonspecific neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil [Internet]. 2017 [cited 2024 May 3];30(4):889–96. Available from: https://pubmed.ncbi.nlm.nih.gov/28282796/
- Petrofsky J, Berk L, Bains G, Khowailed IA, Hui T, Granado M, et al. Moist heat or dry heat for delayed onset muscle soreness. J Clin Med Res [Internet]. 2013 Dec [cited 2024 May 4];5(6):416–25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808259/