Neither heat nor cold may do much for backache

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When back and neck aches strike, do you wonder whether to reach for a heating pad or an ice pack? A small study suggests it may not matter which one you choose.

In fact, researchers say, it seems that neither heat nor cold will do much to ease back or neck pain, at least immediately.

That conclusion might sound surprising, since conventional wisdom holds that cold and heat therapy are effective ways to manage minor injuries such as sprains and strains. 

Often, the advice is to use ice immediately after an injury, then heat in the days afterward.

But there has been relatively little research evidence to back up those recommendations. And few studies have compared heat and cold in helping to ease the short-term pain of strains.

The new study, published in the journal Academic Emergency Medicine, included 60 patients who came to the emergency room for minor strains to the back or neck, most often the back. All of the patients were given 400 milligrams of ibuprofen then randomly assigned to use either a heating pad or a cold pack for 30 minutes.

After the half-hour was up, the researchers found, patients in both groups typically reported mild pain relief.

But the average improvement, as measured by a standard pain-rating scale, was not enough to be “clinically meaningful,” according to lead researcher Dr. Gregory Garra, of Stony Brook University Medical Center in Stony Brook, New York.

And because both groups received ibuprofen, Garra told Reuters Health, what improvements there were may have been brought on by the painkiller.

He said the findings suggest that whether people choose heat or ice for back and neck strains, it is unlikely to bring quick benefits.

The study did not, however, follow up with patients in the days after their injuries, Garra noted. So it’s possible, he said, that either heat or cold, despite a lack of strong immediate effects, might have ultimately led to a quicker recovery.

And since patients in the study all had strains, the findings would not necessarily apply to other types of injuries, including sprains.

Even with the lack of strong benefits in this study, Garra said that people with minor back and neck pain can still feel free to try ice or heat—particularly if they prefer not to take pain medication.

The tactics are cheap, readily available and safe, and in some people they may work via the “placebo effect.” That is, they may perceive less pain simply because they’ve done something to treat it.

“It doesn’t matter which one you choose (heat or ice),” Garra said. “If there’s a placebo effect—then great. They are unlikely to do you any harm.”

SOURCE:

Academic Emergency Medicine, May 2010.

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