Joe, I respectfully disagree with you on icing the lower back.
I do experience serious issues with lower back (and hip joints), and often get pain ranging from P.Scale 4 (and constant) up to a level 8-9 (out of 10). Most recent episodes were from late November, all of December (Pain Scale levels 6 to 8), and into January (upped to a 9 out of 10, at times felt like a 15)....Couldn't walk, stay standing for more than 10 to 15 minutes, and awakened daily in acute pain that affected me viscerally, along with impaired, non-restorative sleep.
My large heating pad was what alleviated my agony.
I spent much time on/off throughout the day with the heavenly pad, propped with pillows. I was so grateful for the comfort and reduction in pain (which at times took hours to achieve). Used Aleve carefully and sparingly, the only pain med that I can take, as well as Blue Emu cream (no odor). Made appointment with pain management doctor, and agreed to steroid shots because I was seriously miserable. Dang those shots hurt! But then again, my derriere is highly sensitive to pain since there are "fibromyalgia points" in that area, so I just clenched my jaw and dealt with it.
That was this past Friday late-afternoon (heavy snow interfered with original appointment date). By Saturday afternoon ALL of the excruciating pain in my lumbar region (and leading UP the spine) was GONE😁. And hip pain was reduced tremendously (Pain Scale Level 5). Have not had to apply heat all weekend thus far, and it is now nearly 6:30 AM on Sunday, two days post injections. And I am actually SMILING today, instead of having misery painted on entire face😁. I can walk, sit, stand, and FUNCTION! I feel as normal as can be, considering what my body dishes out.

I will be seeing a spine specialist, since I have no intentions of dealing with steroid shots for the balance of my life. I don't expect miracles, and I don't favor surgery or implants, so the amazing heating pad will be used as and when needed. But cold on that area for me just cannot happen.
Based on spine MRI (without contrast) done Jan. '23, there is a great deal going on with my lumbar area in particular. (My insurance verified that another MRI can be done since it's been more than a year and pain has progressed.) In radiologist's report (I capitalized certain words): "...mild retrolisthesis at L2-L3 and L3-L4...broad-based posterior DISC BULGE and mild bilateral facet arthropathy resulting in mild bilateral neural foraminal NARROWING and mild central canal NARROWING. Also IMPINGEMENT of bilateral descending L3 NERVE ROOTS within the right and left lateral recesses." As if that were not enough, L3-4 are also affected and shows "...posterior DISC BULGES, with MODERATE TO SEVERE right neural foramina narrowing, moderate left neural foramina narrowing and moderate central canal narrowing; IMPINGEMENT of bilateral descending L4 NERVE ROOTS with right and left lateral recesses." L4-L5 also shows "...DISC BULGE and moderate bilateral facet arthropathy resulting in mild to moderate bilateral neural foramina narrowing but no significant central canal narrowing."
THANKFULLY, L5-S1 shows only mild facet arthropathy, no spinal canal or neuroforaminal stenosis."
Geeesh! Yes, there is a great deal going on in that region. 🤔😳

I won't go to a back orthopedist because a few years ago when there was so much less going on with my back, and such a doctor told me brusquely "Look, I'm a SURGEON! You want surgery, I can do that for you, otherwise I can't help you." Nice, huh? So I walked out and didn't seek further help at that time...But NOW, I will be seeking help of spine specialists, some 18 YEARS after I was brushed off by that haughty, arrogant orthopedist within the medical group to which I belonged at the time.

I'm 75, can't take codeine/morphine or other such drugs, and react horribly to anesthesia (hallucinations and losing consciousness) so surgery is not a viable option for me...looking forward to specialist's assessment and recommendations. And I researching info on a lumbar support pillow. Meantime, the trusted heating pad is within easy reach to use as needed.
Definitely an individual choice, a decision based on what has been effective for each person. I wish only the best for everyone looking to achieve relief.👍🏼😊