Heat therapy for back pain relief Ice massage and ice application is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application such as ice massage therapy provides the most pain relief. Benefits of heat therapy Moist heat, such as a warm bath or whirlpool, is thought to aid the healing process by increasing circulation and relaxing muscle spasms. Whether one uses moist heat or dry heat, the desired effect is for the heat to penetrate down into the muscles.  When warmth and heat penetrate the injured and sore muscles, this provides the dual benefits of: Relaxing the back muscles (to reduce painful spasms) Facilitates stretching the injured tissues to reduce stiffness. As with ice application, when applying heat therapy, care should be taken to avoid burning the skin. “Warm” is the correct temperature for any type of heat source (such as a heating pad, hot water bottle, gel pack, etc.). Also, it is cautioned never to fall asleep with the heating pad on. There is no exact prescription for ice and heat application, and many physicians and physical therapists will recommend trying different forms of heat therapy and cold application to see which approach provides the most pain relief. By: Stephen H. Hochschuler, MD April 12, 2000 (updated March 26, 2003)