Should I Use Ice or Heat?
by Stacey Roberts PT, RN, MSN
Every individual has encountered an injury or pain at some point in life, whether it’s a shoulder injury from an accidental slip, a sprained knee from twisting the wrong way, or chronic pain that manifests due to conditions like arthritis. A common question I often get asked is, for my back, knee pain, neck pain or pulled muscle, should I use ice or heat? Both have unique benefits and potential drawbacks. In this article, I explain when and how to use them to make a significant difference in how fast you heal from an injury and how often you can be active overall.
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Ice for Acute Injuries
One of the general rules traditionally followed is using ice for acute injuries. Acute injuries are usually the result of sudden injuries that result from trauma. These injuries are often accompanied by swelling, pain, redness, and a warm feeling in the area due to the tissue injury and increased blood flow to the affected area.
The RICE and POLICE methods:
For acute injuries, the RICE method has been talked about for years. RICE stands for
- Rest
- Ice
- Compression
- Elevation
A new acronym adds a little bit more information that will help you get better faster. The POLICE method has proven to be highly effective. This stands for
- Protection
- Optimal Loading
- Ice
- Compression
- Elevation.
Initially, PROTECT the affected area from further injury.
OPTIMAL LOADING refers to a balanced and progressive loading, ensuring that the injury is neither overstrained nor underutilized.
ICE is crucial here for acute and chronic injuries – applying it helps in vasoconstriction, reducing swelling and alleviating puffiness and pain.
COMPRESSION and ELEVATION further assist in minimizing swelling and pain.
I often recommend these two products to patients who are looking for compression wraps that also provide ice to help with comfort and decrease swelling. Freeze Sleeve and Theraice are two exceptional products patients love. Both provide exceptional compression and cold therapy without the leaky, awkward ice bags over joints like the ankle, knee, and elbow. For Freeze Sleeve click HERE and to check out Theraice click HERE.
Ice, being a vasoconstrictor, reduces the blood flow to the injured area, minimizing the inflammatory response. It’s a first aid measure that provides immediate relief, reducing pain and swelling. Applying an ice for 10-20 minutes every one to two hours for the first 48 hours can be remarkably beneficial. However, avoiding direct contact of ice with the skin is crucial to prevent frostbite. So if you are using the typical ice bag place a cool damp cloth over the skin as a barrier. But if you choose Freeze Sleeve or Theraice there is no need for a barrier as the innovative materials can protect the skin from damage. I love these two options especially for icing and compression.
Ice for Chronic Pain
In the context of chronic pain, especially in conditions like arthritis, is ice still beneficial? Cryotherapy, as it’s referred to in the research, has shown benefits in decreasing chronic pain (Garcia, 2021). Even without the immediate presence of pain, applying ice to a joint known to be affected by arthritis can stave off inflammation and stiffness as well as provide relief. Ice tends to numb the area, offering an analgesic effect that reduces the perception of pain, and it can also reduce inflammation in the area, to further reduce pain.
The Dual-Edged Sword of Heat
On the other hand, heat serves as a vasodilator, increasing blood flow and helping muscles relax. It can provide immediate comfort and relief, making it a popular choice for many dealing with pain. However, this increased blood flow from dilating blood vessels can sometimes exacerbate inflammation. Over the years I have noticed patients who use heat only note that the warmth can soothe and ease the muscles right away and shortly after removing it, but it has left many patients with increased joint and muscle pain once the immediate soothing effect wears off.
So, while heat therapy (this includes sitting in a hot tub), can be profoundly comforting for stiff joints and muscle tension in the short term, if you note that your joints or muscles are painful and stiff a few hours later, especially in individuals with inflammatory arthritis, then heat alone may not be your best bet.
NOTE: Never use heat for a new injury. Heat will increase the swelling with a new injury. And never leave a heating pad on if you may fall asleep or are not able to pay attention to the area, as you could end up burning yourself.
Balancing Heat and Ice
A balanced approach to chronic pain can sometimes be the best path forward. If you love your heat for chronic muscle or joint pain, following it up with a 10-15 minute application of ice can counteract the potential increase in inflammation. I tell patients to “end with ice”. This combination therapy helps to ensure that you reap the benefits of muscle and joint relaxation from the heat, without the lingering after-effects of increased inflammation due to expanded blood vessels. I would love to see a study on the effects of “ending with ice” since this technique along with our Softwave therapy has helped so many of my patients with chronic pain relief.
Remember, though, no heat for new injuries
Always remember that individual conditions and responses can vary. It is always advisable to consult with a healthcare professional for personalized advice based on your specific health status and needs, ensuring that your approach to managing pain and injuries is as effective and safe as possible.
Safety, understanding, and a tailored approach can transform the healing journey from a winding, uncertain path to a well-navigated road to recovery and comfort.
Let New You Health and Wellness help with acute or chronic muscle or joint pain. Call for a 15-minute free phone consultation or a trial of our Softwave services. Call 414 299 8121 for more information.
Garcia, C., Karri, J., Zacharias, N. A., & Abd-Elsayed, A. (2021). Use of Cryotherapy for Managing Chronic Pain: An Evidence-Based Narrative. Pain and therapy, 10(1), 81–100. https://doi.org/10.1007/s40122-020-00225-w