When Should I Use Heat or Ice?

One question we often get in the office is “Do I use heat, or ice?” The answer is very simple and it depends on the situation and what you are trying to accomplish.

When Do I Use Ice?:

Ice is a great therapy for injuries that are the result of a traumatic event (ie. wrist or ankle sprain, falling down, being hit by an object).  When an injury happens, our body responds with inflammation, which is a normal and healthy process.  Inflammation is evident when there is swelling, heat, redness, and pain to the affected area.  Ice therapy is a natural method that can help reduce the inflammation and pain symptoms by restricting blood flow and ultimately inflammation to the affected area.  Ice therapy can be accomplished by using a bag of ice, bag of frozen vegetables (peas), or standard ice packs.

Ice should be applied to the site of injury for 10-20 minutes at a time, with an interval of time where the ice is off (10-40 minutes).  Ice should not be applied directly to the skin because it can cause superficial damage to the skin (frost bite).  A light cloth can be used as a barrier between the ice and the site of injury.  This therapy should be applied during the first 24-48 hours.  If ice increases the pain or worsens the symptoms you should discontinue use and consult a health provider immediately.

When Do I Use Heat?

Heat therapy is commonly used for chronic pain, muscle tightness, joint stiffness, and stress.  The goal of heat differs from ice in that it increases blood flow to the site of injury to help increase oxygen and nutrient supply. Heat therapy can be achieved by using therapeutic heating methods (paraffin wax, ultra sound, heating pads), a warm towel, or a warm bath.  The heat applied should be comforting and soothing, and should not increase discomfort.  Heat duration can vary but the general rule is to keep the heat on for 10-20 minutes and then to take it off for 20-40 minutes. Moist heat tends to be more effective than dry heat. It is always important to allow the heating pad to breath during use. Do not lay on top of a heating pad, or put it behind you while you sit. This can be dangerous and increase the risk of burning or injuring yourself. All heating devices should be well ventilated.

Simple rule to follow:

If the symptoms of inflammation are there (redness, swelling, pain, warmth) use ice, if they are absent then it is okay to use heat.

Overall, the goal of these therapies is to help improve the site of discomfort by accelerating the healing process.  If the discomfort fails to improve or gets worse, consult your health provider to receive alternative treatment.