Which to Use... Ice or Heat?

March 24th, 2021

Heat or Ice? Which is Better for Your Pain?

If you have ever found yourself with an ache or pain wondering, “Should I apply heat or ice?” you are not alone. It can be confusing which to use and when. Here we’ll explain which situations call for heat and which call for ice, as well as what to do if neither is helping.

As general rule of thumb, it is best to use ice for recent, acute injuries that are less than 6 weeks old, and heat for long-term injuries that have been persisting for over 6 weeks. 

Cold therapies serve to constrict blood vessels, numbing pain and reducing inflammation, which is what you really need for a new injury.

Heat, on the other hand, increases blood flow and soothes tight muscles and aching joints. Heat can increase inflammation in certain injuries, so if one or the other are not working or you are unsure which to use for your particular injury, contact your chiropractor or primary physician for more direction.

Ice or cold packs are best for:

• New injuries
• Strains and sprains
• Sports injuries
• Throbbing headaches
• Gout flare-ups
• Tendinitis (commonly in the shoulder, elbow, knee, and wrist)

Heat or better yet moist heat is often best for:

• Arthritis
• Headaches caused by neck spasms
• Muscle spasms
• Tendinosis
• Relieving stiffness of strains and sprains after inflammation has resolved

Applying Heat and Ice:

Never apply ice directly to the skin; always wrap it in a lightweight cloth or towel.

Apply heat or ice for 15-20 minutes at a time, taking a break of at least as long between sessions. Remove the ice pack or heat wrap if you become uncomfortable. 

A bag of frozen peas or corn makes a great ice pack that molds to the injured area.

Conversely, a warm bath with Epsom salts, a moist heat wrap, or heating pad can be used for heat therapy.

Remember this rule: “Ice first for 48 hours, then heat.” Ice and heat can alleviate local pain that comes from the inflammation associated with muscle and ligament strain. Ice slows swelling and inflammation and acts as a local anesthetic, but after 48 hours, it loses much of its benefit. Using heat afterwards increases blood flow to the deep tissues and relaxes muscle spasms.  A contrast of heat and ice can be very useful to “pump” inflammation out and fresh blood containing oxygen and nutrients in.

When should you seek further treatment?

The advice above will benefit the majority of people with acute or chronic back, neck or joint pain. But, if any of the following guidelines causes an increase in your discomfort, a spreading of pain, numbness and/or tingling or weakness in the arms or legs, do not continue your home therapy, and call our chiropractic office for direction. In the event you cannot contact us and feel you are in an emergency situation, please contact your primary physician, or seek care at urgent care or the emergency room of a hospital.