HEAT THERAPY
All You Need To Know
Updated: July 30th, 2022
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Hot packs can help reduce your low back pain and keep you moving. But you need to know when heat is right. And how to do it correctly.
THE BASICS
WHEN & WHY TO HEAT
Hot packs are great for sore muscles. They tend to be the right move when you have a chronic low back and want to "loosen up" the joints. Most likely you are really loosening up the muscles surrounding the joint. This is achieved by promoting blood flow to the muscles. When you place heat on an area, your body responds by expanding the blood vessels. This allows more blood and oxygen to be delivered to the area. Better circulation tends to reduce muscle stiffness and pain. COMMON CONDITIONS FOR HOT PACKS - Muscle soreness a couple days after exercising - Arthritis - Chronic pain (fibromyalgia) - Muscle spasms WHEN NOT TO HEAT THE LOWER BACK - You have an injury significant swelling or redness in the area. - You have an infection. - You have a blood clot. - Over open wounds - Over areas of impaired or altered sensation (numbness, tingling etc.) - If you have a bleeding disorder. - Over joints with acute hemarthrosis (bleeding in a joint.) - Local tumors are present - Have existing skin problems characterized by redness or blistering. This list is general in nature. Contact your physician before trying heat.
HOW TO HEAT
Duration: Heat for 15-30 minutes at a time Use a Skin Barrier: Place a towel between your skin and the hotpack. This will help avoid any damage to the underlying skin. Intensity: You want the heat to be comfortable. Listen to your body. If it feels too warm, add another layer or take a break. Check Skin: Make sure you are not damaging the underlying skin by checking occasionally. Frequency: 3-4 times a day is the maximum we would recommend using hot packs. Make sure you take at least a couple hours break between sessions. - Never sleep on a hot pad. Once again, listen to your body! Heating should not hurt. If it does, ease off.
THE EVIDENCE
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EVIDENCE RATING: GOOD
Their is moderate evidence that low back heat therapy is beneficial. One study reviewed the existing evidence and concluded heat therapy provides a small, short-term reduction in pain and disability for a low back pain population (1). Critically, it noted the addition of exercise further reduces pain and improves function. The amount of relief was relatively small and only lasted for a short time. Another study by Lloyd et al examined the cost-effectivenes of low-level heat wrap therapy on lower back pain and concluded the heat wraps could be a cost effective approach to reducing lower back pain (2). A study we found compelling compared low-level heat therapy to ibuprofen and acetaminophen. They concluded the continuous heat wrap therapy was more effective than both the medication interventions at treating low back pain (3). NOTE: The Agency for Healthcare Research and Quality, an official website of the Department of Health and Human Services, gives heat wraps a rating of "Medium Evidence."(4)
REFERENCED STUDIES
1. French et al. Superficial heat or cold for low back pain. Cochrane Database Syst Rev. 2006 Jan; 2006(1): CD004750. Published online 2006. 2. Lloyd A, Scott DA, Akehurst RL, Lurie‐Luke E, Jessen G. Cost‐effectiveness of low‐level heat wrap therapy for low back pain. Value in Health 2004;7(4):413‐22. 3. Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Hinkle RT, Goodale BM, et al. Continuous low‐level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain. Spine 2002;27(10):1012‐7. 4.https://effectivehealthcare.ahrq.gov/products/back-pain-treatment/clinician
YOUR OPTIONS
HOT PACKS
Hotpacks you can buy over the counter are easy to heat up and reusable. These have come a long way in recent years. Today's units have features such as multiple heat settings, auto-shutoff, and even cordless battery powered options.
WARM WATER
Who doesn't love the feeling of settling into a hot tub? This can be a nice and simple option for general soreness. Particularly, if you have more than one area of the body you need to apply heat to. Make sure the water is not too hot. A good temperateure is between 90-100 degrees. Be even more careful if you have a history of heart problems.
HOT COMPRESS
You can make a homemade heating pad quite easily. Put a wet washcloth in a freezer bag and warm it in the microwave for around a minute (this will vary dependong on the size of the towel and power of your microwave.) Be careful when taking it out of the microwave. Check it with a few taps of your fingers to make sure there are no super hot spots that could injure your skin. Place the warm compress on the sore region for 10-20 minutes.
Hot packs can be an effective tool for low back pain, particularly for chronic issues and muscle soreness. Supporting evidence is good. While potentially useful in the first 48-72 after an acute injury or back pain flare-up, we recommend caution when using heat during this period.
CONCLUSIONS
THE BEST
Cool Relief | Flexikold
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Best Sitting
or Lying Down
WHY WE LIKE IT
We loved the weight and even heat transfer of the Pure Enrichment Weighted Warmth Pad. It fits snugly around your mid-section and maintains an even heat whether lying on your back or side. Excellent heating pad while working in a seated position as well. The entire heated surface is approximately 18 inches (length) by 8 inches (high), which is more than enough to get the job done.
Easily portable. Four standard heat settings, so you can find the one that works right for you. This hot pad does require a plug-in, which shouldn't be an issue unless you want to heat while on the move (see our second pick below if that's the case.) For a dedicated heating pad we prefer plug-in's over heating them up in the microwave. It's faster and simpler overall.
This company also has a reputation for excellent customer service. And a 5-year warranty.
FEATURES
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4 settings allow you to find the right heat intensity
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Filling is guaranteed non-toxic, BPA-free, lead-free, and phthalate free
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Micromink material is easy to maintain
CONCLUSIONS
Our clear recommendations for a lower back hot pack if you prefer to heat while sitting or lying down.
Our Pick
WHY WE LIKE IT
The Arris Gel Ice and Hot Pack for Back Pain Relief stands out for it's large gel pack and double-pull tension straps. Let's start with the gel pack, which is filled with 800g of heatable gel (1.77 lbs), which was the biggest gel back we found with a wrap around support sleeve. It provides a large area of heating for approximately 15-20 minutes duration.
Regarding the support, the double-pull tension straps provide two things: First, additional support to prevent loosening or slipping of the gel pack. This is key if you are wearing it while on the move. Second, it can provide additional compression to support your back.
While not marketed as one, it is essentially a light back brace and heating/ice pack in one. We have mixed feelings on low back braces (see our Back Brace Review to learn more), however when lightly tightened it does a great job of helping to keep the heat therapy in place and adding an extra sense of support. Just don't come to rely on the brace part too much. We want your core muscles working to support your back - not a brace.
Can also be used as an ice pack. NOTE: Icing is it's primary purpose and, in fact, it is our first choice for lower back icing.
PROS
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Reusable, good warmth for a mobile hot pack
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Stays in place well
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Can be used for light back support
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High-quality, durable
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Icing (primary use) option as well
CONS
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Just one gel pack provided (for us this is a non-issue)
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Straps could lead to reliance as a back brace. Be careful to not let this happen.
CONCLUSIONS
It's a great hot pack for lower back pain if you are on the go. The combination of large gel pack, quality, price, and stabilization straps make it hard to beat.