Should I put Ice or Heat on it? I get this question a lot.  Both hot and cold packs can be a great healthy alternative to medication.  But which one is best?

ICE

Ice can help to reduce pain.  It is very effective to control inflammation and swelling.  Studies indicate that the application of a cold pack can slow down the activity of the nerve cells for pain.  It’s ability to control inflammation occurs because it narrows the size of blood vessels, preventing excess fluid from building up in the injured area, which keeps swelling at bay.

HEAT

Heat can also effectively help to reduce pain, decrease muscle spasm, improves tendon and ligament flexibility, and increases blood flow.  Researchers aren’t quite sure how most of these benefits work, though it seems that heat releases endorphins that help block the communication of pain signals, and can calm down the nerves that make muscles uncontrollably spasm.

Heat temporarily increases the size of your blood vessels which allows more blood to flow to the area.  So when a joint or muscle is inflamed and swollen, it makes sense to avoid adding more fluid to the area by applying heat.

SO WHAT’S BETTER, HOT OR COLD?

There’s a ton of research on the effects of both, and for the most part the results aren’t conclusive.  Based on our clinical experience working with patients for years here’s some advice:

• If it feels warm and swollen, ice it.
• If you sustained your injury is less than 3 days ago, follow the RICE principles (Rest, Ice, Compression, Elevate (above the level of your heart).
• If you have taken and responded well to a medication such as Nurofen, Voltaren, or Ibuprofen these are what are referred to as Non Steroidal Anti-inflammatories so you would likely respond better to ice.
• If your injury is more than 3 days old, use heat or ice (try both and see what works better).
• If your injury is more than 3 days old, and the effect of ice/heat has diminished, try both! (heat for 2 min, ice for 2 min, repeat 5x).
• For muscle spasms or tightness, try heat and be sure to hydrate.

Heat can applied for 15-20 minutes, ice for 10-15mins.  Check the area often to ensure you’re not getting a burn or frostbite.

BE CAREFUL!  This advice should only be considered as a part of a proper assessment.  Application of the wrong source of heat or cold and length of time it is applied can be detrimental or cause further harm.