The Great Debate: Ice Vs. Heat

One of the best and easiest self-treatments you can do for yourself at home when dealing with pain or an injury is to apply ice or heat to the area.  Although this may sound simple, therapeutic icing and heating — cryotherapy and thermotherapy — remains quite confusing for patients and even controversial in the scientific literature.  My goal for you in this blog is to help clarify the issue and provide you with some simple guidelines.  Let’s break things down.

 

So! Ice or Heat?

 

Ice for the most part, is for injuries. Cold helps to calm down acutely damaged tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy and normal process that also happens to be sometimes incredibly painful.  You can consider icing to be a mild, drugless way of dulling the pain of inflammation that helps reduce swelling. In essence, ice helps constrict the blood vessels and helps numb your pain.  Ice can be applied using a dry or damp towel to help protect the skin. Use cold gel packs, ice cubes in a ziploc bag, or even a bag of frozen peas.  Ice for 15 to 20 minutes.

 

Heat is for muscle tension/spasms, joint stiffness, chronic pain, and stress.  Heat helps take the edge off symptoms like muscle aches and stiffness. Chronic pain, especially back pain, often involves a lot of tension and anxiety, and comfortable heat can help soothe a worried mind and nervous system.  Applying heat increases blood flow and helps relax the nervous system and problem area.  Heat can also be used before exercising to help loosen up tight muscles. To apply heat, use a heating pad, a hot wet towel or warm shower.  Heat for 15 to 20 minutes.

 

A note of caution! If there is inflammation in the area, heat can temporarily make the area significantly worse. On the flip side, ice can also alternatively aggravate symptoms of tightness and stiffness – as seen in sore muscles or trigger points.  Now, in the case of an acute muscle tear or strain, the rule of thumb is to ice first for a few days, (to get the inflammation down) then switch to heat.  In the case of arthritic pain, unless a joint is severely inflamed (in which case you should use ice), feel free to experiment with both and figure out what makes you feel better.  Alternating between applications of ice and heat is also an option and some patients find that helpful in facilitating injury recovery and alleviating their pain.

 

At the end of the day, it is important to use whatever feels best to you! If you get goosebumps at the thought of applying ice to an injury in the dead of winter, be my guest and try using heat instead.  As long as your injury isn’t brand new or in a state of mass inflammation, feel free to experiment with both ice and heat.