Hot packs for low back pain



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit




Heat therapy can provide pain relief 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.

Many episodes of lower back pain result from strains in the muscles and soft tissues.

Heat therapy can help relieve pain from the muscle spasm and related tightness in the lower back.

Heat 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 modulates the perception of pain in superficial nerve fibers.
•Heat helps with stretching the soft tissues around the spine, including muscles and connective tissue. Consequently, with heat therapy, there will be a decrease in stiffness with an increase in flexibility.


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.

Heat therapy works best when combined with other treatment modalities, such as physical therapy and exercise. It has the advantages of being a non-invasive and non-pharmaceutical form of low back pain relief.

The right temperature is important. The heat should be warm and not hot. Patients should not have the heat source be hot to the point of burning the skin.

For 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 1 hour). Prolonged use of a heat pad is not indicated since it can lead to skin burns.

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

•Dry heat is the easiest to apply and some people like it better than moist heat.
•Moist heat, such as hot baths, steamed towels or moist heating packs can help with penetration into the muscles, and some people feel that moist heat provides better pain relief.


If you do not have a heating pad, you can use a moist soft terry cloth hand towel.

Some other common options include:

•Hot water bottle - tends to stay warm for 20 to 30 minutes. Cover the bottle with a moist towel to prevent burn. A hot bath or shower might also help
•Electric heating pad maintains a constant level of heat.
•Heated gel packs - may be microwaved, or heated in water, and tend to say warm for about 30 minutes.
•Heat wraps wrap around the lower back and waist and may be worn against the skin under clothing.
•Hot bath, hot tub, sauna, steam bath 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.

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 inflammation or swelling.

Heat therapy is an easy and inexpensive option to provide relief from many forms of lower back pain. It is a valuable part of many lower back pain treatment programs.





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