Do you put hot or cold on a herniated disc?

When it comes to treating a herniated disc, both heat and cold therapies can provide pain relief and reduce inflammation. Choosing between hot and cold depends on the stage of injury, level of pain, and personal preference. In the early stages of a herniated disc, cold is generally recommended to reduce swelling and inflammation. As healing progresses, heat is often more beneficial to promote blood flow and relax muscles. Some find alternating hot and cold therapy provides the most relief. Consult a doctor to determine the best treatment plan for your individual condition.

Quick answers

Here are quick answers to common questions about heat vs. cold for a herniated disc:

  • In the early stages (first 2-3 days), cold is generally better to reduce inflammation.
  • After the first few days, heat is often more effective to promote healing.
  • Ice or cold packs should be applied for 10-15 minutes several times per day.
  • Heating pads, hot packs, or warm baths can be used for 15-20 minutes at a time.
  • Never place ice directly on skin – wrap in towel to prevent cold burns.
  • Alternating hot and cold therapies may provide optimal relief for some.
  • Always follow medical advice and stop if therapies increase pain.

What is a herniated disc?

A herniated disc, also known as a slipped or ruptured disc, occurs when the soft inner gelatinous core of an intervertebral disc pushes out through a tear or weakness in the outer fibrous casing. This inner nucleus pulpous material can put pressure on the spinal nerve roots causing pain, numbness or weakness in the area supplied by those nerves. Herniated discs are most common in the lumbar spine but can occur at cervical and thoracic levels as well.


There are several factors that can lead to a herniated disc:

  • Age: The discs lose hydration and elasticity over time leading to tears.
  • Injury: Sudden heavy lifting or twisting can cause disc tears.
  • Wear and tear: Years of minor strains adds up and weakens discs.
  • Improper lifting: Using back instead of legs to lift heavy objects.
  • Poor posture: Increased pressure on discs from slouching.
  • Genetics: Some people inherit weaker connective tissues.


Common symptoms of a herniated disc include:

  • Lower back or neck pain
  • Pain, numbness or weakness in legs or arms
  • Pain that radiates down the leg or arm
  • Tingling or numbness in extremities
  • Muscle spasms in back or extremities

Symptoms can vary greatly depending on the location and severity of the herniated disc. Seek prompt medical attention if significant numbness, weakness or loss of bowel/bladder control occurs.

Should you use heat or cold for a herniated disc?

Both heat and cold therapy can be beneficial for treating the symptoms of a herniated disc. Here are some general guidelines on when to use each approach:

Use cold in the early stages

Applying cold is recommended during the first 2-3 days after a herniated disc injury. Cold therapy constricts blood vessels, reduces blood flow to the area and limits inflammation. This helps diminish swelling, muscle spasms and pain signals. Cold also has a numbing effect for rapid pain relief. Cold should not be applied directly to the skin – wrap ice packs in a thin towel to prevent cold burns or frostbite.

Use heat after the first few days

After the initial inflammation has subsided, applying heat promotes healing by increasing blood flow to deliver oxygen and nutrients while removing damaged tissue. Heat also reduces muscle tension and pain signals. Methods like heating pads, hot packs, warm baths or heat wraps are ideal for this stage. Take care not to overheat and avoid sleeping on heating pads.

Consider alternating hot and cold

Some find alternating the use of hot and cold packs provides optimal relief, especially during the transition from early inflammation to healing. This involves applying ice for 10-15 minutes followed by heat for 15-20 minutes and repeating as needed. The contrasting temperatures may help pump fresh blood and nutrients into the area. Discuss this option with your doctor.

Follow up with your provider

It’s important to follow up with your healthcare provider to determine the best use of hot and cold therapy for your individual injury and symptoms. Your doctor can advise on when to begin heat, recommend specific techniques and issue cautions if needed.

Cold therapy for a herniated disc

Here are some key points on properly using cold therapy to treat a herniated disc:

  • Apply ice packs wrapped in thin towel for 10-15 minutes every 2-3 hours initially.
  • Use ice packs, gel packs or bagged frozen vegetables rather than direct ice.
  • Gradually reduce cold therapy as symptoms improve over 2-3 days.
  • Avoid direct skin contact which can cause cold burns.
  • Try an ice massage by freezing water in a paper cup and rubbing over back.
  • Some devices like cold compression wraps or chilled spinal braces can be used.
  • Discontinue if cold increases nerve pain or numbness.

The cold temperatures reduce blood vessel dilation and fluid leakage to quickly decrease inflammation and swelling around the affected nerves. This can rapidly alleviate associated muscle spasms and pain. Cold should not be applied for more than 15 consecutive minutes to prevent tissue damage.

Potential benefits of cold therapy

  • Reduces inflammation and swelling
  • Constricts blood vessels
  • Numbs pain signals
  • Decreases muscle spasms
  • Prevents additional fluid leakage

Risks and cautions with cold therapy

  • Avoid direct skin contact to prevent cold burns
  • Limit initial use to first 2-3 days after injury
  • Discontinue if nerve pain worsens
  • Not recommended for people with circulation issues
  • Can be uncomfortable initially before numbness sets in

Heat therapy for a herniated disc

The following are tips for safely using heat to promote healing after the acute inflammation phase:

  • Apply heating pad, hot packs or heat wraps for 15-20 minutes 1-2 times daily.
  • Take warm baths or showers with care not to overheat.
  • Gradually increase heat use over 1-2 weeks post-injury.
  • Avoid sleeping on heating pads which can cause burns.
  • Hydrate well before using heat to prevent dehydration.
  • Stop immediately if heat increases pain or numbness.

The increased blood circulation provides oxygen and nutrients to help heal damaged tissues and dissolve inflammation byproducts. The warmth also relaxes tight muscles and blocks pain signals for soothing relief.

Potential benefits of heat therapy

  • Boosts blood flow to deliver healing components
  • Relaxes tightened muscles and spasms
  • Blocks pain signals for soothing relief
  • Increases tissue flexibility and range of motion
  • Promotes removal of inflammatory waste products

Risks and precautions with heat therapy

  • Avoid during first 2-3 days when inflammation is high
  • Can increase swelling if applied too early
  • Stop immediately if numbness or nerve pain increases
  • Hydrate well and avoid overheating
  • Do not sleep with heating pads to avoid burns

Other remedies and treatments

While hot and cold therapies can provide relief, it is important to see a doctor for an accurate diagnosis and to rule out serious complications. Other treatment options may include:

  • OTC medications: Oral over-the-counter anti-inflammatories and pain relievers.
  • Prescription medications: Oral steroids, muscle relaxers or neuropathic pain drugs.
  • Epidural steroid injection: Steroid injection near the herniated disc to reduce inflammation.
  • Spinal decompression: Use of traction device to relieve pressure on discs.
  • Physical therapy: Specific exercises to strengthen and stabilize the spine.
  • Surgery: Removal of herniated portion or entire damaged disc as a last resort.

Hot and cold therapy can be very beneficial when used properly in conjunction with other medical treatment under the guidance of a health professional.

Hot and cold therapy guidelines

To maximize the benefits of heat and ice for a herniated disc, follow these guidelines:

  • Use cold in first 2-3 days to reduce acute inflammation.
  • Apply heat after initial inflammation subsides to stimulate healing.
  • Do not place ice directly on skin – use towels or cloth barrier.
  • Start with short sessions of 10-15 minutes cold and 15-20 minutes heat.
  • Gradually increase heat therapy duration as tolerated over 1-2 weeks.
  • Stay well hydrated when using heat therapy.
  • Consider alternating hot and cold therapy for optimal relief.
  • Stop immediately if numbness, tingling or pain worsens.
  • Discuss proper use of hot and cold with your doctor.


Both cold and heat offer therapeutic benefits for treating the symptoms of a herniated disc. Cold works best immediately after injury to control inflammation while heat promotes healing in the subacute phase. Always exercise care when applying hot or cold treatments. It is important to follow medical advice and closely monitor symptoms and pain levels. With proper hot and cold therapy integrated into a comprehensive treatment plan, recovery from a herniated disc can be greatly improved.

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