When Do I Use Heat vs. Ice with an Injury?

Apr 4, 2022

Injuries

After an injury, we all think — should I apply heat or ice to this part of my body? Will one be better than the other, or will I make things worse if I use one or the other?

This blog post gives tips to understand whether you should use heat or ice with these common injuries.

Acute Injuries:

An acute injury is one that happens suddenly and is usually associated with trauma. Trauma with an acute injury can include but is not limited to cracking a bone, tearing a muscle, or spraining your ankle. Common signs of an acute injury include sudden and intense pain, swelling, tenderness to the injured area, and inability to move the joint through its range of motion.

When you have an acute injury, the best form of modality is ice due to the swelling likely to occur in the area.

Arthritis:

Arthritis is a disease that affects your joints and typically involves stiffness, swelling, and degeneration of your joints. There are many types of arthritis, but the most common types include osteoarthritis and rheumatoid arthritis.

When you have arthritis, the best form of modality is heating to relax the surrounding muscles and assist with any joint stiffness. Ice may be the better option for you directly afterward if you have a flare of up of swelling following physical activity.

Headaches:

Whether you experience frequent headaches or migraines or get an occasional headache here and there, you know they can knock you down from time to time. While taking OTC medication or getting some rest can help, you can also try heat or a cold pack.

Cold masks across your forehead or eyes can help soothe the pain if you have a throbbing headache or migraine.

If your headache comes from spasms or tightness in the neck, putting a hot pack around the back of the neck and shoulders can help relax the muscles and calm the mind.

Sprains or Strains:

Muscle sprains or strains include anything ranging from rolling your ankle, pivoting during an activity, twisting the knee awkwardly, or overextending a joint.

Initially, after an injury like this,  there will typically be swelling or redness, or tenderness of the injured area. When this occurs, inflammation in that area will respond well to the ice to ease the inflammation and numb the pain.

After the swelling and inflammation have gone down and you are still experiencing stiffness in the area, heat can help relax and loosen up the tissue and improve mobility.

Tendonitis:

Tendonitis is a painful inflammation issue that affects the tendons, the connective tissue between your muscles and bones. Typically, with tendonitis, there is inflammation. Repetitive activities such as running, tennis, shoveling, typing, raking cause this. Since there is inflammation, ice is usually the preferred method of modality as it can help numb the pain and ease the swelling in the joint.

Tendinosis:

Tendinosis is like tendonitis, but this is a chronic and long-term condition caused by a degenerating tendon. Heat is best for relieving stiffness of the joints that go along with this condition, but only after reduced inflammation.

So Now That I Know What Modality to Use — How Do I Safely Apply Heat and Ice?

There are many ways and options to apply ice or heat with these injuries. The general rule of thumb is to leave it on for 20 minutes and off for a minimum of 20 minutes.

For both heat and ice, use a layer of toweling over the desired packs to reduce the risk of burns. You can get burns from both heat or ice if you leave them on for too long or are too hot or cold. If you have neuropathy or an area with poor sensation, be aware of putting heat and ice on that area. Check the area frequently as you have decreased sensation and can still get burnt. Set timers and be sure to never fall asleep with the ice or heat on.