Ice or heat for injury?
If you’ve ever suffered from chronic pain or pain from an injury, you probably know that an ice pack or heating pad can be the difference between constant pain and temporary relief. It can even speed up the healing process.
But when is it right to apply heat, and when is it best to apply ice?
As a rule of thumb, ice is best for fresh injuries while heat helps stiff, aching muscles. However, it’s not always that simple, and administering the wrong treatment can make things worse.
When to apply ice
Ice is typically used to treat acute, fresh injuries. Ice helps calm down inflamed, red, hot, swollen tissue. Inflammation may be your body’s natural reaction to injury, but it is quite painful. Applying ice is a simple, mild, drug-free method of dulling pain and reducing swelling, bleeding and muscle spasms. If you’ve pulled a muscle, sprained your ankle or have a case of IT band syndrome, try an ice pack. It can also help with certain chronic conditions, like overuse injuries in athletes. However, always ice the injury following activity, and never before.
You can make a cold pack at home by filling a resealable plastic bag with ice cubes and wrapping it in a towel. A bag of frozen peas is also an excellent choice. Whatever you use, apply the cold pack early and often for the first 48 hours following the injury. Make sure you never place ice directly on your injury, and never ice it for longer than 30 minutes. Move the ice pack around to avoid giving yourself a cold-induced burn (frostbite), and remove it if your injury turns pink or red.
When to apply heat
Heat therapy is an effective treatment for sore muscles, chronic pain and stress. Chronic pain can also cause tension, anxiety and hypersensitization, and a heating pack is effective at soothing the nerves and mind. Heat helps relax and loosen tissues and stimulate blood flow to affected areas.
When using heat treatments, such as a heating pad or a hot towel, make sure to apply it before participating in strenuous activities rather than after. Never use heat treatments on a fresh or an acute injury or in a situation where swelling is involved. Swelling occurs when tissue bleeds, and heat just draws more blood to the area. Also be sure to moderate the amount of heat you use and the length of time you use it to avoid burns. Never leave a heating pad on for an extended period or while you’re sleeping.
When the line is blurry
So you’re supposed to ice injuries, not muscle pain, right? But what happens when you have an injured muscle, like a muscle tear or strain? That’s when things get a little more confusing. In the end, the answer is usually ice, at least for the first few days. If the muscle is truly injured, ice will help with inflammation and pain. Once the initial pain has subsided, switch to heat. Pay attention to your body, how it responds to treatments and follow what feels right. If you try something and it doesn’t help, switch it up.
When to leave your injury alone
Ice and heat have the potential to inflict temporary harm on your body if used incorrectly. Heat can aggravate inflammation, and ice can worsen tightness and stiffness. Both can make your pain worse if you’re not careful. The brain interprets excess heat and cold as a threat, and can send signals to your body that exacerbate your pain.
In general, never use either heat or ice:
- On areas of the skin that are damaged or in poor condition.
- On areas of the skin where you already have difficulty sensing heat and/or cold.
- On areas of the body that suffer from poor circulation.
- If you have dermatitis.
- If you have deep vein thrombosis.
- If you have an infection.
- If you have diabetes.
- If you have multiple sclerosis.
Never use ice packs on your left shoulder if you have a heart condition, and don’t use them on the front or side of your neck. Talk with your primary care provider before using heat therapy if you have heart disease, hypertension or if you’re pregnant.
When to see a doctor
If you’ve tried heat therapy and ice therapy but aren’t experiencing significantly better results, it might be time to consult with your doctor. Our skilled physicians are here to diagnose and treat your pain. Contact Onward Orthopedics to schedule an evaluation today by submitting an online form or by calling one of our friendly Patient Care Managers at 210.880.3823.