How Does Heat Work?                                              Heat opens the blood vessels of the muscles surrounding the neck and back. This increases the flow of oxygen and nutrients to the muscles, helping to heal the damaged tissue.  Heat facilitates stretching of the muscles and ligaments around the spine, leading to a decrease in spasms, stiffness and injury, with an increase in flexibility and overall feeling of comfort.

What Are The Types?                                                                                      Dry heat, such as electric heating pads and saunas, draw out moisture from the body and may leave the skin dehydrated.  However, some people feel that dry heat is the easiest to apply and feels the best.  Moist heat, such as hot baths, steamed towels or moist heating packs can aid in the heat's penetration into the muscles, and some people feel that moist heat provides better pain relief.  A specific type of heat therapy may feel better for one person than for another, and it may require some experimentation to figure out which one works best. Some common options include:

• Hot water bottle - tends to stay warm for 20 to 30 minutes.
• Electric heating pad - maintains a constant level of heat as long as it is plugged in.
• Heated gel packs - may be microwaved, or sometimes heated in water, and tend to say warm for about 30 minutes. Certain types of gel packs provide moist heat, which some people prefer.
• Heat wraps - wraps around the lower back and waist and may be worn against the skin under clothing, providing convenience and several hours of low level of heat application.
• Hot bath, hot tub, sauna, steam bath - tend to stimulate general feelings of comfort and relaxation that may help reduce muscle spasm and pain. A whirlpool jet directed at the lower back may provide the added benefit of a light massage. 

When Do You Use Heat?                                                                                   Ice massage and cold therapy 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.  Some prefer to use heat prior to physical activity (to warm-up the muscles) and cold after activity (to decrease inflammation).

Safety Tips:

• Treatment should not last more than 30 minutes
• During treatment, check the skin every 5 minutes to make sure it is not getting burned
• Do not lie on a hot pack or heating pad to avoid falling asleep and potentially burning yourself
• Do not use heat if you have no feeling in the affected body part
• Do not use heat if there is swelling or bruising; cold therapy is better in these situations
• Do not apply hot water bottles or gel packs directly to the skin; use a towel as insulation
• Do not use heat if you have poor circulation, such as occurs with diabetes
• Do not use heat on open wounds or over stitches
• Do not use heat on areas of the body with dermatitis, deep vein thrombosis, or peripheral vascular disease