Which is Better for Injuries: Ice or Heat?
Almost everyone has had an injury and been told to "put some ice on it". Just about everyone has had an injury and been told to "use a heating pack". Who is right? What is the difference? How can you be sure that you are using the more beneficial treatment?
Ice or heat for treating injuries have been around for many years and are based on theories of proper healing. There are many different forms of these therapies including cold packs, heating pads, ice cubes, ice baths, certain heating lamps, menthol-based creams/sprays (e.g. Biofreeze), and many others. Although neither treatment option has been shown to be therapeutically superior for every condition, there are some generalized guidelines when deciding which to use based on your condition.
When to Use Ice:
Ice is best used with the goal of decreasing blood flow, controlling inflammation, and reducing pain sensitivity. It is best to use with a new injury such as a sprain/strain, tendonitis, bursitis, and others. These injuries require inflammation and swelling for the healing process, but sometimes this swelling can be too much and cause further damage known as secondary injury (1). Ice is used to prevent this excess swelling by causing blood vessels to constrict, slowing the flow of blood and inflammatory chemicals into the tissue.
Overall, ice is best to be used after more recent injuries to reduce pain and control the immediate swelling and inflammatory cascade.
When to Use Heat
Heat is best used for chronic injuries that are associated with stiffness, soreness, or tightness of the joints/muscles. The goal of heat is to increase blood flow to the area to help improve the function of the tissue that is injured. Contrary to ice, heat causes blood vessels to dilate which brings in more blood to the area of injury. This increased blood flow helps to relax muscles, reduce spasm, and improve joint stiffness.
Overall, Heat is best used when wanting to warm up and relax sore muscles and joints. It should not be used within 48 hours after an injury as this could cause further damage by increasing inflammation in the area.
How Long Should I Use Ice/Heat?
Ice: 10-15 minutes at a time. A few times a day.
Heat: 10-15 minutes at a time. Whenever muscles/joints are feeling tight or stiff
There are no universal guidelines for either therapy and the recommendations are largely based off of your particular type of injury.
Does Research Support Ice/Heat Modalities?
Most of the recommendations above for ice and heat are based on physiological rationale. The research for ice and heat when treating injuries is mixed, but they have shown some effectiveness for pain relief and improving function (primarily heat), along with some studies showing no benefit (2, 3).
Although ice and heat are a very conservative treatment option, there are still some conditions where they may be contraindicated and cause further complications. It is important to ask your trusted healthcare provider for recommendations about which modality to use and how to use it. Because the research has been mixed, it may be best to decide for yourself whether either of these treatment options provide relief. Some people choose to let "nature take it's course" and let the body heal without the assistance of either, while others swear by these modalities to assist the healing process, both of these options are correct as you should choose whatever works best for you.