Heat or Ice

Heat or Ice? Wondering which you should use?

Ice or heat? This is a question we get regularly from our patients. Typically, a patient’s goal is to decrease pain and speed up recovery from an injury. Historically speaking, ice was the go to for almost every injury. It was thought that no matter the stage of the injury you wanted to decrease inflammation in the area. It is now known that a mild amount of inflammation can actually be beneficial to help the body heal.  So let us break it down for you and help sway you one way or the other. 

 

When Should I Ice?

Ice is almost always recommended as the top choice for acute injuries. It can be used to help decrease the initial pain and inflammation. An acute injury is one that has happened recently and is not long standing. Icing the area decreases pain by numbing the area, as well as decreasing circulation and overall inflammation. How long (i.e. days) you want to ice is really dependent on the severity of the injury. If there is significant visible swelling, you can continue cycles of icing. This can  until the pain decreases and the visible swelling is decreased.

It’s also important to understand that not all inflammation is bad. Inflammation is a natural response to injury and if the inflammation is minor it can actually aid in recovery. In order to get the most benefit, you want to ice for 10-20 minutes at a time. You also want to ensure the ice is not directly on your skin to prevent frostbite. 

 

What About Heat? 

Heat has the opposite effect of ice on the tissues. The warmth brings an increase in circulation, while helping to loosen muscles and soothe the nervous system. In addition to the direct effects on the area of pain, heat may also have a relaxing effect on the body in general. Unlike ice, heat can be used for prolonged periods of times (i.e weeks) and will continue to provide relief. 

Heat can be used for ongoing conditions that have become more chronic. Chronic meaning that is has been present for a longer period of time, or it is an ongoing issue from repetitive strain.   Injuries that respond well to heat may low back pain, muscle strains (after the first couple of days), neck pain and headaches. When you apply heat you want to focus on applying steady heat for 10-15 minutes on and off for 2-3 cycles. 

 

The Common Factors: 

One of the things that ice and heat have in common is that they both help decrease the sensation of pain. Decreasing perceived pain alone can be enough of a benefit to encourage individuals to apply heat or ice. Additionally they can both cause injury to the skin if applied improperly. It’s important to make sure that you don’t leave them on too long or apply them at too high or low of a temperature. 

It’s always important to take into account how your body or injury responds to each modality. Even if you have a chronic injury, sometimes heat can increase the pain. It’s important to listen to your body and determine how you respond to heat and ice. If you heat a chronic injury and it causes an increase in pain, it is worth trying a round of ice to see if that provides improved relief. 

Lastly there is something I like to prescribe to patients called the heat/ice oreo. This is where you apply ice to the main area complaint, and then heat above or below (or both) to relax the muscles surrounding the main injury. Not only can this provide some increased relief, but it typically makes ice more comfortable for those that don’t enjoy the cold.

 

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