You Ask, We Answer: When to Use Heat Versus Ice

Probably the question I get asked most often is when is it appropriate to use heat and when is it appropriate to use ice?  And depending on which medical professional you ask, you may get a different answer from each person.  That is because there really is no definitive right and wrong answer.  And depending on when you graduated from medical school will most often dictate this answer as the thought process has changed as the research has evolved.  The best advice currently is, when in doubt, ice.

Generally when people are seeking a form of cold therapy (ice) or hot therapy (heat) that person is in pain.  This usually means that there is swelling occurring at the site of the injury.  Cold therapy or ice is most often warranted in this situation because ice is a vasoconstrictor.  This means that it will slow the blood flow to the area and therefore reduce the pain.  For more information on physical therapy services head to

Most often people will be told to use ice within the first 48 hours and then after that use heat.  Ice can be and should be used beyond the first 48 hours.  The 48-hour rule that health care professionals most often refer to is the definition of an acute injury.  When we refer to an injury as being acute, it usually has occurred within the last 48 hours and that is when most people are told to ice.  However, ice is helpful well beyond the initial 48 hours and can continue to help reduce swelling and therefore reduce pain.

The best way to ice an area is to apply an ice pack or a bag of ice.  The ice pack or bag of ice should be wrapped in a towel or cloth and NEVER be applied directly to the skin.  The ice should be applied for a period of 10-15 minutes.  Icing longer does not mean that you will heal faster; in fact it could have some adverse consequences if kept on too long.  Ice, however, should NEVER be used before an activity.  If you feel the need to ice, you should always apply the ice after the activity.

Heat is often used in chronic conditions.  A chronic condition is described as a condition that has been going on for several weeks, months and even years.  The best description of a situation I usually give to people with respect to using heat, is if you come home after a day of work and your back is sore or you wake up and your back is stiff.  You are not feeling pain but it is more of a stiff or sore feeling.  Then it is advised to use heat.  Heat is a vasodilator and increases the blood flow to the area.  This increase in blood flow will allow the muscles and surrounding structures to loosen up and reduce the soreness.

Moist heat or any type of heat that can be applied that gets cooler over time, is the most advisable form of heat.  Heating pads that are plugged into the wall are not advised as they do not get cool over time and may wind up burning you.  Any type of heat is properly applied with layers of towels in between the heat and the skin so you will not burn the skin.  If you are going to be laying directly on the hot pack, then add extra layers of towels to protect the skin.  Heat may be applied for a period of 15 – 20 minutes.  It is not advised that you heat an area any longer.  Heat should never be applied directly to the skin.  Heat should NEVER be applied within the first 48 hours of an injury and should never be applied immediately prior to vigorous activity.

Regardless of the injury always consult a healthcare professional before the application of any hot or cold therapy.

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  1. Pingback: If it hurts don't do it, YES it is that easy! - Total Performance

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