Question: Help me settle a bet with my wife: Is it better to ice a sore back (just muscle strain, from too much tennis) or apply heat?

Dr. Hibberd's answer:

Cool packs or ice are best used early on, especially in the first 24 to 48 hours. But warm packs and heat are better for easing pain after two to three days, as their use earlier in strains may cause increased swelling and inflammation.

Back injuries are slightly different, and many patients get relief by alternating heat and cool packs.

But I still prefer to wait on the heat application, then alternating between warm and cold compresses. Sometimes a pulsating source — such as a shower — may be precisely what the doctor ordered.