Should you use an ice pack or a hot wheat bag for your back pain?

Back pain is a common musculoskeletal issue in Australia, with around 15% of Australians experiencing it at any given time. When faced with pain, many people instinctively turn to medications as the first line of treatment. However, as a physiotherapist, I believe that heat and cold therapy are often underutilized alternatives. These methods are effective, safe, and come with minimal side effects, making them an easily accessible option for pain management. Research, including studies published by Cochrane, supports their benefits, and the Royal Australian College of General Practitioners also recommends them too.

Should you reach for a cold pack or a hot wheat bag?

Your body may have already given you some clues about which treatment you prefer. For example, you may feel relief after a hot shower. If you’re unsure, I recommend trying both heat and cold to see which one offers the most comfort and pain relief. You should be able to determine which works best for you fairly quickly.

Key Tips before for using heat or cold therapy:

  • Always place the heat or cold pack over a towel or a t-shirt to avoid direct contact with the skin and prevent burns

  • Check the sensation of your skin before applying a pack. If you have reduced sensation, speak to your therapist as you will need to be extra cautious to avoid burns

  • Aim for 20-minute sessions, 3-4 times a day.

Heat Therapy Options:

  • Hot water bottles

  • Wheat bags (soft packs filled with grain)

  • Hot towels

  • Hot baths

  • Saunas

  • Heat wraps

Cold Therapy Options:

  • Ice packs

  • Cold towels

  • Cold gel packs

Written by Adrian Thomas Davies.

References:

https://www.cochrane.org/CD004750/BACK_superficial-heat-or-cold-for-low-back-pain

https://www1.racgp.org.au/ajgp/2024/september/best-practice-care-for-acute-low-back-pain

Kristin Haigh