Do I use heat or ice?

Quite often blog ideas are sparked by questions that our clients ask… and this is one that we get on a very regular basis.

Should I be using ice or heat?

Ice or heat therapy can be some of the most effective, simple and safe self treatment options for many painful problems, however when used poorly they can potentially do more harm in the short term than good.

While there are always exceptions we are going to give you some basic guidelines that should help you make a bit of an educated decision.

If in doubt always ask, it’s an easy question for us to answer if we get a brief idea of what is going on.

When to choose ICE

Ice is definitely your best option for most ‘fresh’ acute injuries where there is a specific incident or trauma. For example a rolled ankle, twisted knee, stubbed toe or corked thigh. The aim of the ice is to reduce the swelling & inflammation which is the body’s natural response to trauma. This in turn will also assist with controlling pain. If you ice an injury straight away and continue to apply ice during the initial 48 hours  you can effectively help control the inflammatory process in the damaged tissues and potentially reduce recovery time. Think of ICE as a drugless way to dull the pain!!

Another time ice can be used is when returning to sport or activity after an acute injury. For example following your first run back from a sprained ankle; icing after can help to manage any secondary swelling that may appear when you begin to stress the injured joint.

** Be careful of ice burns! don’t apply ice directly to your skin, always have a cloth or ice pack cover and check the skin intermittently. Ice should not feel so cold that it’s burning!!! 20-3o minutes is a good amount of time for an ice application.

When to choose HEAT

More chronic conditions with no specific incident is where heat is going to work better. For example lower back pain that is brought on with prolonged sitting or tight neck and shoulders. The aim of heat is to stimulate blood flow to the area, reduce muscle spasm and tightness which can in turn assist with relieving pain. Warm muscles are generally more relaxed, which makes movement easier. Movement is medicine and the sooner we can get a stiff, tight area moving the quicker the recovery.

EXCEPTION – We mentioned that ice is the choice for acute injuries BUT when it comes to necks and backs we actually tend to prefer HEAT.  For example if you wake up with a stiff, sore neck apply a heat pack. Why? often with backs and necks there is alot of associated muscle spasm which drives the pain response cycle. Heat helps to relax muscle spasm which can calm down the central nervous system and reduce pain.

Here are some simple guidelines to follow – if n doubt there is no harm in asking

  • ICE is for fresh injuries and is most effective in the first 48 hours.
  • DO NOT HEAT A FRESH INJURY – heat and acute inflammation are not a good combination.
  • If there is visible swelling pick ice
  • Don’t ice directly before activity. Heat is a better option before activity to warm up the muscles and stimulate blood flow.
  • If you have chronic (long term) pain or muscular tightness heat is generally going to work better.
  • You can ice/heat for as long as you want within reason. Gone are the days of the 20 minutes on 20 minutes off application. Use common sense; if it’s too hot, you feel flushed and uncomfortable, or the ice pack is freezing cold take some time off.
  • Always have a barrier such as a cloth or towel between the heat or ice and your skin and be mindful of applying either overnight.
  • If you have circulatory problems and find it hard to feel changes in temperature you should check you skin intermittently during an ice or heat application to make sure you aren’t burning yourself!

Hopefully that clears up a little of the confusion. Remember if in doubt always ask!