When a physician sees a patient who is suffering severe back or neck pain, he or she understandably wants to prescribe potent pain relief, an opiate. Since back and neck pain is so common, it's also understandable that it's a primary reason so many opioids are prescribed and an all-too-common cause for opioid addiction.
Needing non-addictive pain relief for our patients, we sought an option that is safe, effective, inexpensive and readily available for anyone when they need it. The solution is the aggressive use of ice, applied exactly as physics and physiology demand. Applied correctly and repeatedly, ice slows pain transmission to the point of numbness, thus controlling the acute pain. Just as importantly, ice "flushes" the area with elevated blood flow that occurs minutes after an initial decrease in blood flow caused by the cold. Tissue redness after the ice is removed is evidence the area has been fed, oxygenated and purged of waste products, all good things.
The problem is, the effect doesn't last very long so ice must be applied frequently, but safely. Use pebble ice mixed with water in a latex or vinyl, one-quart ice bag, rinsed thoroughly on the outside, and closed tightly. Apply directly to the bare skin and hold in place with a towel folded lengthwise. Do not lie upon the ice pack. The effect is complete in 20 minutes and may be repeated every hour, depending upon severity. Leaving the ice on for longer periods is of little value and is not recommended. We found that chemical, gel, and grain cold packs are soothing but not as effective as wet ice packs and present the risk for "burn" because they are dry and their temperature is unpredictable. They come from a zero-degree freezer and the water in skin cells freezes, thus injuring the cells, a little below 32 degrees Fahrenheit.
Acute back or neck pain responds best when wet ice packs are applied as soon as possible following injury or pain onset and then hourly during the first 24 hours. Continue the use of wet ice packs for the next 36 hours as often as feels reasonable. Athletes and others find predictable benefit from daily use of ice packs until pain and symptoms have passed.