Ice or Heat - How to Decide

Most everyone has experienced an injury of some sort that requires extra care in order to relieve pain, reduce inflammation and speed healing. Usually either ice or heat is recommended to help achieve these goals, but how do you know which to choose? Both heat and cold can be beneficial in certain circumstances, but each can also cause more harm than good if applied at the wrong time. Following are a few guidelines to help you decide on the best course of treatment.

ice or heat

The first general rule is to ice an acute injury and apply heat to a chronic injury. Swelling and inflammation is your body’s natural first response to injury - your blood vessels expand in order to rush more blood to the area to begin the healing process. So the best thing to do within the first 24 hours of an acute injury is to apply ice. This will allow the blood vessels to contract, reducing inflammation and bringing down the swelling, in addition to acting as a pain reliever by helping to calm irritated nerves.

Ice or cold packs should never be applied directly to the skin, as this may cause frostbite. They can be wrapped in a damp washcloth or towel, or even simpler is to use a bag of frozen peas. Ice should be applied to the injury for 10 to 20 minutes every two hours within the first 72 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours, unless it is used to aid recovery after a strenuous athletic workout, or to help reduce inflammation after an instrument assisted soft tissue mobilization (IASTM) treatment .

Heat treatment is most useful for chronic injury, as it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. For example, sitting in a hot tub may feel good, however, the following day you will likely feel more pain and stiffness due to the increased inflammation it has caused. Heat can also reduce joint stiffness and muscle spasms.

Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm rather than hot treatments should be used to avoid the risk of burns, and heat should never be applied for an extended period of time or while you are sleeping. Heat treatment is also useful in cases of chronic injury, such as overuse injuries in athletes, shoulder impingement syndrome, bursitis and tendonitis.

If you're still uncertain which treatment to use, consult with a qualified physician.  At Denver Sports and Family Chiropractic Center, we are trained in treating acute injuries and getting you back on your feet as quickly as possible.