When do you use ice? When do you use heat?
From a soothing hot water bottle to a bag of frozen peas, most of us have turned to heat or ice at some point to help relieve pain. But when something hurts, choosing the right one means faster relief of soreness, stiffness, swelling, and inflammation, while choosing the wrong one can actually make the problem worse.
I see so much confusion from patients about whether to use hot or cold for their pain. And that’s unfortunate because cryotherapy (ice) and thermotherapy (heat) are cheap, easy, and safe at-home treatment options for many aches and pains.
So, if you remember nothing else from this post, remember this: Ice is for joints & injuries, and heat is for muscles.
Ice is for joint pain and acute injuries
Ice should be used for joint pain or for a new injury that is causing swelling/inflammation. Joints hate swelling and extra fluid build-up.
Ice fights inflammation by constricting underlying blood vessels, decreasing blood flow to the area. This reduces swelling as well as the amount of histamine at the injury site, one of the main propagators of the inflammatory response.
Ice therapy should be kept to 15-20 minutes at a time, followed by allowing the area to warm back up for at least 45 minutes before beginning the icing routine again.
Don’t allow ice to sit directly on skin without a layer of protection. Either continually move the ice (“ice massage”) or use a thin towel between ice and skin.
People with sensory disorders that prevent them from feeling certain sensations should not use cold therapy at home, because cold therapy applied for too long or too directly can result in skin, tissue, or nerve damage. This includes diabetics, who may have reduced nerve sensitivity.
Heat is for muscle pain or stiffness
Heat therapy works by improving circulation and blood flow to a particular area – muscles love better blood flow. Increasing the temperature of the affected area even slightly will bring extra fluid to a muscle and improve flexibility.
Heat therapy can be used for a good amount of time, unlike cold therapy, which needs to be limited.
If the area in question is either bruised or swollen (or both), it may be better to use cold therapy. Heat therapy also shouldn’t be applied to an area with an open wound.
People with certain pre-existing conditions including diabetes, dermatitis, vascular diseases, DVT, and multiple sclerosis should not use heat therapy due to the higher risk of burns or complications from heat.
When should I alternate heat and cold?
The guidelines above are good rules of thumb, but there are two cases where alternating heat and cold might be better than either alone.
Osteoarthritis: While there are no universally accepted guidelines, many patients with arthritis use heat therapy in the morning to loosen up a stiff joint(s) and then use cold therapy to reduce swelling later.
Rehabilitative Exercise: Rehab patients often benefit from using heat therapy to warm up a joint(s) before physical therapy and then using cold therapy afterward.
How do I correct the underlying problem?
If you’re receiving chiropractic adjustments as part of your care, then you already know the answer. Chiropractic addresses the mechanical and neural aspects of the underlying cause of the pain. Recent research from JMPT found that low back pain patients who receive chiropractic care have a 60% decrease in pain, which was nearly 10% MORE relief than those who received corticosteroid injections or medication. It’s excellent pain relief while also correcting its cause – all with a chiropractic adjustment.
Live in Northwest Indiana and looking for a chiropractor? We'd love to help you get started with chiropractic care. Make an appointment at R2 Wellness Centers by calling 219-696-8916 or request an appointment with our online booking link.