Heat or Ice


Ice and heat are two more of the modalities that we use in our office to help provide symptomatic relief to patients.  There is a long standing debate as to which is better to use for musculoskeletal injuries hot packs or ice.  Some people only use ice, some only heat, and still some say that you should rotate using Ice for 20 min. then heat for 20 or vice versa.

The easiest way to explain when and which to use is to tell you what they do.  Ice is generally used in acute injuries, so within the first 48-72 hours after you get hurt.  We use it then to control the swelling, reducing the inflammation, relieving the pain and reducing the risk of secondary injury.  Ice can do this because the cold causes the blood vessels to contract thus reducing the amount of fluid/blood that can get to the area.

Heat is generally used to improve healing by bringing more blood flow through the area. Just the opposite of ice, heat dilates the blood vessels increasing the amount of blood that can come into and out of the area treated.  We use heat for chronic problems or after any inflammation is under control.

Most people prefer heat to ice, but both will provide some temporary pain relief, so if you have a preference go with that.  If you find that using one or the other provides relief during the application, but then increases the problem after; discontinue it’s use.  The best example of this is taking a hot shower, if you have an acute injury it will feel good, but as soon as you start to cool down you’ll notice that the blood is not getting out of the problem area and just swelling causing more pain.  So if you have just worked out and might be sore or just injured yourself, ice.  If you need to warm up or have a chronic problem that needs to heal, heat.


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