what is it made of, sand?

actually a special kind of mud.....the outer shell is tough canvass

would this fit a 22 inch neck?

Yes, it will.... We use it for lower back also. It helps my husband significantly on his neck.

Can it be heated in a boiling water pan

It can be heated in a pan of boiling water but the water should not be above 165 degrees. The recommended heating range is 160-165 degrees.

can be used for hot and cold therapy ?

No it cannot. The is a hydrocollator pack. Goes in Hydrocollator Machine. A hydrocollator is a stationary or mobile stainless-steel thermostatically controlled liquid heating device designed to heat bentonite-filled packs in water up to 160 degrees where the packs will be removed and wrapped in several layers of toweling and applied to the affected body area of a patient to relieve acute ... to heat or heat is hot water. These are not for cold therapy.

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The MOLLE sheath is of exceptional quality. Very happy with my purchase.

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Chattanooga00-1012 Hydrocollator Moist Heat Pack, Knee, Shoulder, 10" x 20"

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