Ice or heat for low back pain?

New recommendations make it simple. For acute (recent or new onset) low back pain, use ice for 20 minutes every hour as needed. Heat, for the same time and frequency, should be applied when you have chronic or a long-standing history of low back pain (LBP). However, when you have chronic LBP you may use ice for acute flare ups above your baseline of pain (i.e., if your baseline of chronic LBP is a 5/10 and you have an acute episode when your pain goes higher then ice should be used until your pain returns to 5/10 or your baseline). Heat wraps may be worn for 8 hours and increases blood flow to back muscles.