When to Use Ice Versus Heat

Larry A. Law

Is there a rule for when to apply ice versus heat for relief from injuries, aches, and pains? It always seemed confusing to me, but an article I read recently helped clarify things and I thought I would pass this information along. It turns out that, in general, heat helps to soothe ongoing muscle aches and pains while ice works best after a sudden injury. A good acronym to help remember for injuries is RICE: rest, ice, compression, and elevation. Ice works for injuries because it constricts blood vessels; that helps prevent blood from pooling at the injury site. Too much blood will add to inflammation and swelling while delaying needed healing. This is why elevating the injured limb is helpful since it reduces blood flow to the area and minimizes swelling. Ice should be applied for 48-72 hours to reduce secondary tissue damage and ease pain. Apply the ice for about 20 minutes once an hour. Don't keep it on longer as you don't want to damage your skin or lead to frostbite. Avoid direct exposure and use a cloth or towel between your skin and the ice.

When to Use Heat

For muscle aches and pains, applying heat will help increase blood flow to the wounded area; this will encourage healing while soothing the pain and increasing flexibility. As blood flow increases, the flow of oxygen and nutrients does too. In addition, waste material is cleaned out quicker too. Heat is especially good for joint pain and as a pre-workout warm-up. Gel packs or heated water bottles work well and don't pose the risk associated with electric heating pads (electromagnetic fields—EMF). In general, pain that is chronic and not related to swelling responds best to heat treatments. As with ice, apply the heat for only 20 minutes at hourly intervals and use a barrier between your skin and the heating source.