The Cold Truth: Ice is Nice for Chronic Back Pain Relief

chronic back pain relief
Terri Night
Written by
Terri Night Physical Therapy

Many of my clients have trouble with the idea of putting a freezing cold anything anywhere, let alone on their back. Even if I tell them it’s for chronic back pain relief. I can’t even count the number of times I’ve heard the line, “I hate ice—it’s so…cold.”

But if you can just get over the initial shock of it, I’m telling you, ice works wonders for all types of chronic pain relief—and especially so for the neck and back.

There are two ways ice can help to relieve chronic pain.

  • Increases circulation to the deepest parts of your muscles.
  • Slows the conduction of pain signals to the brain.

Some people try ice once or twice, and decide it doesn’t work. I recommend using no more than 10 minutes of ice at least twice daily, for five consecutive days. By the end of those five days, you and your pain level should be in a better place.

How Ice Works

Using ice for just ten minutes improves blood flow to your spine. You’ve heard of hypothermia?  A person exposed to extreme cold in the wilderness goes into shock. In this state, the superficial blood vessels constrict and the deeper blood vessels open up, shunting blood to the vital organs needed for survival.

When you apply ice to your low back, you essentially trick your body into a sort of localized hypothermia. Deep spinal muscles and joints receive a nice, much-needed infusion of blood and nutrients. The result is spasm-reduction and a deep muscle relaxation.  This is only the first of the awesome things ice does for you.

Using ice for just ten minutes reduces the level of your pain. Lower temperatures slow things down—and this includes nerve conduction. Basically, it’s too darn cold for the nerve to send those angry pain signals up the spinal cord to the brain.

Pain signals travel along the spinal cord to the brain. When a nerve cell fires a pain signal, it travels at a certain rate:  SOS   SOS   SOS   SOS   SOS.

If the pain is more intense, the signal travels along a little faster: SOS SOS SOS SOS. 

Pain is like a pot of simmering water. If you add heat to your aching back, the water simmers faster or starts boiling: SOSOSOSOSOSOSSSSSSSS!!!!!!

Take the heat away and it calms down. Put ICE in the water and the boiling slows to a stop.


If you are experience severe low back struggles, using ice can give you chronic back pain relief.

How to Use Ice Correctly

Check with your doctor or physical therapist first to make sure it’s safe to use ice.

Use ice without a lot of layers in between. A single pillowcase or paper towel is enough to protect your skin. A towel is probably too much layering and will not provide the full effect. Your ice pack should be cold, not just cool. 

An ice pack should be left on no more than 10 minutes. This prevents frostbite. Use a timer with an alarm to prevent yourself from forgetting or falling asleep. Check you skin afterward to make sure there’s no irritation. 

Use soft ice—a soft ice pack conforms to your body’s contours. (That old-fashioned clunky ice bag can help a little, but sometimes you want your cold therapy to cover more than just a few inches.) I recommend buying a gel pack from the local pharmacy or you can order a couple on-line.

Use strategic ice. Always ice over the center of your spine, but it may help to try it out on other areas too (right buttock, outside of the thigh, etc…). Always use ice in a position of comfort.Never use ice over an area of numbness. This precaution also helps to prevent frostbite.

Always Use Ice in a Position of Comfort

Lie on it with your feet up on a chair, bolster, or sofa (a.k.a. the 90/90 position) or just with a few pillows under your knees.

Lie on your side with a pillow between your knees and strap it to yourself using a sheet, elastic-waist pants, or a lumbar corset (see next section) Get your grandkid to hold it on!

Lie on it in your groovy faux-leather recliner! And make sure you set a timer! Use your ice pace for 10 minutes at a time

Different Types of Ice Packs

Gel packs. Best for conforming to your body’s contours. Buy in a medical supply store, local pharmacy, or on-line. I recommend the Chattanooga Colpac neck contour pack for all parts of the body.

Frozen vegetables (peas, corn, or black-eyed peas). Inexpensive option, but can be lumpy and uncomfortable. May work better if you spread them out inside a one-gallon Ziploc bag. Note: Do not eat after use!

The Ideal Icy Reception

Hate the idea of putting ice on your spine? Use visualization to lessen the initial shock. Imagine your back is on fire. As the ice comes into contact with your skin, imagine the sound of a hot skillet being plunged into cold water. Sssssss. Ahhhhh.

Some people just cannot tolerate ice, and some even have an allergy to ice. But if you haven’t given it a fair shake (2x/day for 5 consecutive days), and your doctor says it’s safe to use for  chronic back pain relief, why not give it a try? You may be glad you did.

Note: Always consult a physician before beginning any new exercise program or treatment plan. This article is not a substitute for medical evaluation and diagnosis by a physician.

Terri Night
Written by
Terri Night Physical Therapy

Terri Night, PT is the author of Rehab Your Own Spinal Stenosis: strategies to improve the health of your spine. As a licensed physical therapist specializing in back pain, back surgery rehab, and chronic pain management, her presentations have been featured at Physician Grand Rounds for Alta Bates and Summit hospitals, as well as several Bay Area senior centers and health expos. For more information visit

This article is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.

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