Heat or Ice? The Ongoing Debate

The question I get asked most at ActiveLife Rehab and Wellness is, ”Should I apply heat or ice when I have pain?”

Honestly, we don’t blame patients for asking this question because this has been an ongoing debate, even in the health community. Heat is generally used to promote more circulation to an injured area, providing it with more nutrients and oxygen to aid in healing. The warmth can help to alleviate pain, relax muscles, decrease muscle spasms and increase range of motion of the affected joint. Ice, on the other hand, helps to decrease circulation to the area, thereby reducing swelling, inflammation and pain.

So what is the big difference between the two? Simply put, heat will increase circulation and ice will decrease circulation. Both modalities are useful and effective only if used at the right timing in the course of your injury. Therefore, the biggest question is, “when?”. Here are some general guidelines on when to use ice or heat.

When to use Ice?

You should use ice within 24 to 48 hours after an injury. It is not recommended to ice after this time frame as it may delay healing of the injured tissues. The main goal of icing at this time is to help reduce or prevent excess swelling that may occur during your body’s inflammatory response to the injury. You may use ice again if you re­aggravated the injured area and caused more swelling. Ice should be applied for no more than 20 minutes and you should wait an hour before re-­applying it again.

When to use Heat?

After the initial 48 hours of an injury, you may start to use heat. The main goal of heating at this point is to bring more blood to the area to stimulate healing of the damaged tissues. You can also use heat if you are suffering from muscle spasms, chronic injury and joint or muscle stiffness. Heat should be applied for no more than 20 minutes and you should wait an hour before re­applying it again.

If you are unsure about the nature of your injury or have any doubt as to whether to apply heat or ice to an injury, you should contact your health care provider for more information. Feel free to bring up this question of Heat or Ice the next time you see me at the clinic.

Leo Wan, HBSc.Kin, MSc.PT

leowan@activeliferehab.ca

#physiotherapy #heat #ice #inflammation