Ice or Heat: How to Determine the Best Way to Treat an Injury

Apr 26, 2021

ProActive Physical Therapy

by ProActive Physical Therapy

When sprains, muscle strains, inflammation, and general pain come at you, knowing exactly when to use ice or heat can significantly shorten your recovery time.

So, what do you choose, ice or heat? This a question we receive from a variety of patients many times a week. These patients are often searching for an alternative to pain medication, which can be expensive and even addictive for some. The use of ice and heat is a cheap, usually low-risk option that can be effective for pain management.

When Should You Use Ice?


Placing an ice pack on an injured ankle.In general, ice is used to calm down swollen or inflamed tissue immediately after an injury. Swelling is your body’s natural response to injury – the inflammatory process is a healthy, normal, but often painful process that causes damaged tissue to become red and swollen. Unfortunately, local swelling can also lead to compression of nearby tissues, which causes further discomfort. Using ice, we can reduce the pain of inflammation without having to resort to drugs. Cold should only be applied locally, and it should never be used for more than 20 minutes at a time. Over-icing can cause frostbite, and patients with decreased sensation or neuropathy should especially take caution. Exactly how long and how often a patient should ice an injury depends on a variety of factors that a physical therapist can assess, but generally, for the first 72 hours after an injury, it can be iced at least 3 times per day for 10 to 15 minutes each time. After 72 hours, some people will respond better to heat, and they can try using heat to alleviate pain and promote healing.

When Should You Use Heat?


Heat pack being applied to the lower back.In contrast to ice, heat should be used for muscle issues, chronic pain, and stress. Applying heat to an area of the body increases blood supply, stimulates the elimination of toxins, and relaxes stiffness and soreness to bring relief. It is often used on an ongoing injury just before exercise, and it is typically more effective than ice for treating muscle spasms, low back pain, and neck pain. Heat is usually more soothing to the nervous system and the mind than ice, and it often helps relieve pain from a chronic injury. When applying heat, be sure to protect yourself from direct contact with the heating source by wrapping it with a towel to prevent burns, stay hydrated, and make sure not to fall asleep on a heating pad. Generally, heat should be applied 1-3 times a day for 10-15 minutes at a time – however, if heat is added too early in the healing process it can perpetuate the inflammation cycle and be harmful to the body.

Ultimately, the decision to use heat or ice is up to you. Your body might respond differently to heat or ice, so try different variations of both treatments to determine which ones you find most effective. If you have recently been injured and are dealing with pain, a physical therapist can evaluate you and help you to determine an appropriate course of action for treatment. Contact your local ProActive Physical Therapy clinic today if you have questions about pain management!

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