"Doc, should I use heat or ice?" If I only had a dollar for every time I've heard that question. Bottom line... if you hurt yourself lifting, running, bending or performing any type of sports activity, DON'T Heat It!!! Have you ever seen a trainer apply heat to an injured athlete? Have you ever seen a pitcher heat their shoulder after pitching 6 or 7 innings? No you haven't. You'll always see these players with ice. Usually a big bag of ice ace bandaged to the injured or strained area.
So when you're suffering with pain always think of the above scenario. Ask yourself, why do I hurt? If you were doing some heavy yard work, if you tweaked your back at the gym, if you twisted your ankle, these are all activity/athletic style injuries which require ice for the first 2-4 days post injury. Often, if the ice is applied soon enough, the injury will improve in about half the time.
When you think of ice, think about putting out the fire of inflammation. When we get hurt, the injury itself creates and inflammatory cascade. Think about this cascade as a fire in your body. Would you add heat to put out a fire? Of course not. We use ice to put out the fire. This goes for backs and necks as well as other joints. Many people wouldn't dream of heating a twisted ankle, but wouldn't hesitate to heat a strained back. What we need to understand is that there is no difference! Trainers, chiropractors, PT's, orthopedists; we all treat athletic type injuries the same regardless of location: we treat them with ice.