ice vs heat

Ice versus heat – what to use for pain relief

Ice vs Heat – Should I use ice? Should I use heat? Will one help or hurt me? The use of ice or heat is one of the most controversial topics in health care. It has been studied over and over again. It is also one of the most commonly asked question patients ask us, whether they are coming in with acute pain or with chronic ailments. Let’s explore the benefits and recommended times of usage for both.

Acute vs Chronic affects Ice vs Heat

Acute pain is defined as: pain that comes on suddenly, caused by something specific, and lasts less than six months.

Chronic pain is defined as: pain that is ongoing following an injury or illness and lasts longer than six months.

When to use ice?

With an acute injury, it is believed that the first 72 hours are critical in reduction of inflammation and prolonged injury. Ice should be the go to treatment when an injury first occurs. This includes sprains, strains, and bruises that will increase inflammation quickly. When an injury occurs, vessels within the body open up to allow blood flow to enter the area. This allows the bad elements within the area to be taken away and bring oxygen and nutrients into the area to promote healing. While this can be beneficial, the sudden inflow can cause inflammation, increase pain, and decrease range of motion. Ice causes those vessels to restrict and decrease the massive increase in inflammation and bruising that can occur when blood pulls to one area.

Ice can also be used to treat chronic conditions, such as bursitis and tendonitis. It can be beneficial to reduce muscle guarding related to pain. It is believed that the ice slows the speed of nerve communication to the brain, reducing pain.

When using ice, it is common to experience the following sensations: cold, burning, aching, and finally numbness. For the most benefit, it is recommended to place the ice directly on the skin or over a compression wrap to decrease inflammation. It should be left in place for about 20 minutes and can be repeated every hour.

When to use Heat?

Heat is not advised to be used within the first 72 hours of an injury. Heat is to be used to dilate the vessels, increasing blood flow to an area. This is beneficial later the healing process.  Heat is used to increase the collagen elasticity within the tissue, decrease joint stiffness, decrease pain, and increase blood flow. It is also believed that heat can also send signals to the brain faster than the pain signals, decreasing the feeling of pain. Generally, heat is used best to reduce muscular tension and spasm.

When using heat, it is important to feel a warm soothing sensation but not a burning feeling. Commonly electric heating pads or rice/corn are used at home. These can be placed directly onto the skin’s surface. For the most therapeutic benefit, it is best for the heat to be applied for 15-20 minutes at a time and can be repeated every hour. It is important to never lay directly on the heating pad, as this can increase the chance for burns. If you are using the heat and feel yourself dozing off or falling asleep, be sure to set a timer so the heat is not on for too long! Burns can occur.


  • Low back pain – ice for the first 72 hours after injury, then heat.
  • Headaches
    • Migraines – ice only
    • Tension or neck spasm – heat only
  • Arthritic pain – heat only
  • Shoulder pain – ice for first 72 hours after injury, then heat.
  • Knee pain – ice for first 72 hours after injury, then heat.

We want you to feel good

Dr. Miller and Dr. Murdock will be more than willing to provide further guidance or give advice regarding ice or heat benefits and proper usage times. At Miller, we also offer other services including laser therapy that will work like heat to improve blood flow to the injured area.  Contact us today to set up an appointment so we can help you feel better now.

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