When to Use Ice vs. Heat for an Injury

Articles by Dr. Jerry Gore / When to Use Ice vs. Heat for an Injury
ice pack

You’ve just finished an amazing workout at the gym, but as you begin your cooldown it’s clear you pulled a muscle. Or maybe you exited the car less-than-gracefully and you worry you twisted your ankle. Yikes!

In situations like these many of us know we should either ice an injury or apply heat, but choosing the wrong one will aggravate symptoms and put our health at risk. When do we use ice vs. heat for injuries? When is the right time for these natural pain remedies?

Ice Vs. Heat for an Injury

The general rule of thumb for determining whether to use ice or heat: ice is intended to reduce swelling and inflammation. Use ice on acute injuries that have occurred in the last 48 hours. Heat packs are reserved for chronic pain and conditions to loosen tissues and stimulate blood flow.

However, there are many details to consider and exceptions to the rule. Before you grab a frozen bag of peas or spring for a hot water bottle read the following.

When to Use Ice on an Injury

Ice treatment is reserved for fresh injuries. Ice is primarily used for instances of tissue damage, like an ankle sprain. Other common injuries that you would ice include:

  • Joint or knee sprain
  • Intense pain after a workout
  • A pulled muscle
  • A body part that is visibly red and swollen

Icing can also be used for chronic conditions such as muscle overuse in athletes, in which case the ice should be applied after activity to prevent and reduce inflammation. Note: Do not use ice packs on your left shoulder if you have existing heart conditions, as this can be dangerous.

How to Ice an Injury

When you know you are dealing with an acute injury, it is best to apply ice as soon as you can. Icing is a cheap and effective home remedy to reduce pain and hopefully limit the inflammation.

Apply ice or a bag of frozen vegetables to the site of the injury and elevate the injury if possible. Limit icing sessions to 20 minutes every hour — applying ice for an excessive amount of time can damage your skin tissue.

Icing often during the first 48 hours after an injury has occurred is the best way to keep swelling down and reduce pain. If your symptoms are still acute after a few days visit a doctor or naprapathic practitioner who can diagnose the injury accurately.

When to Use Heat on an Injury

Heat treatment is used for chronic conditions and pain that recurs frequently. Injuries and conditions that call for heat include:

  • Muscle soreness
  • A past severe injury
  • Arthritis
  • Joint stiffness

For athletes with overuse problems, applying heat before activity will loosen muscle tissue and lessen the likelihood of further injury.

Do not use heat treatments after exercise when your heart rate and body temperature is elevated. Also, do not use heat treatments when swelling is involved. Swelling is caused by tissue bleeding, and heat will draw more blood to the injury site.

How to Apply Heat to an Injury

You can heat an injury by using a heating pad or pack, or by applying a damp, hot towel. A method as simple as taking a hot bath or shower may also provide some relief and relax your muscle tissue.

To avoid irritating or damaging skin tissue, use moderate heat for no more than 20 minutes. Applying excessive heat can cause blisters or even burns. Never leave a heating pad on overnight, as this can cause medical problems and constitutes a fire hazard.

Heat therapy can help relieve chronic pain and provide relief for sufferers of certain conditions, but it doesn’t work on every case. If your chronic pain won’t go away, schedule an appointment with Dr. Richard Bisceglie, a naprapathic practitioner, or a primary care provider such as Patricia DeAngelis, APRN, or Cheryl Schwartz, DO, who can determine if you have any underlying issues with your ligaments, bones, or tendons.