Ice vs Heat: Which Therapy is Best for Acute Injury Treatment and Chronic Pain Relief?
I often get asked when to use ice or heat therapy. Both can help with pain and speed up recovery. You can use ice packs, moist heating packs, or brand-name gel products like Icy Hot, Biofreeze, or Sombra. Saunas and ice baths are also options. In my office, I use ice packs, moist hot packs, and Sombra gel because it doesn’t have waxes, oils, or alcohol and needs little application. Biofreeze only offers cold therapy (which makes sense), however Sombra has cold and warm gels coupled with optional CBD ingredients.
But before you start buying/using these products, let’s look at the science of Cryotherapy (Ice Therapy) and Thermotherapy (Heat Therapy) so you know what to choose.
Ice therapy functions to reduce blood flow to a specific region, with the goal to reduce inflammation and swelling that is caused by pain. It also slows down nerve activity, and therefore, reduce pain signals.
Heat Therapy functions to increased blood flow, helping to relax muscles and joints and promotes increased healing by bringing more oxygen and nutrients to the affected tissues. Heat can also help reduced muscle stiffness and increase mobility.
So both can reduce pain even though the mechanisms are the complete opposite.
Use ice therapy for acute injuries. Acute injuries can be defined as any incident occurring during the first 48-72 hours. It can be used for conditions such as:
Sprain/strains
Tendonitis
Bruises and contusions
Post Surgery recovery
Inflammation from Overuse
A good example of an acute injury would be a knee injury. Using ice therapy will help constrict the blood vessels, reduced swellling, and numb the pain. Apply ice for 15-20mins maximum, with one hour between applications in order to avoid damage to the skin. Wrap a towel around the ice pack to avoid frostbite.
Common methods of ice therapy include:
Ice packs
Ice massage
Ice baths
Cryo chambers
Gel packs or sprays
With heat, the mechanism is the opposite. Heat helps to loosen up tight tissues, reduce stiffness, and increased mobility. So an adult with long standing lower back pain can benefit from heat packs in order to loosen lower back muscles, and increased flexibility.
Use heat therapy chronic conditions such as:
Chronic muscle pain
Stiff Joints (arthritis)
Delayed onset muscle soreness (DOMS)
Lower back pain
Menstral cramps
Some common methods of heat therapy include:
Heating pads
Hot baths or showers
Infrared heating devices
Moist hot packs
Gel packs (ie. Sombra)
Diathermy
Apply heat for up to 20mins to avoid burns.
Those experiencing post-workout soreness can alternate between ice and heat therapy, also known as contrast therapy. Gels are great for prewarmups as they help to prevent injury as well.
Some Limitations and Precautions
Avoid ice therapy if:
You suffer from Raynaud’s disease (a condition where there is poor circulation)
You have open wounds
You experience numbness in the area
Avoid heat therapy if:
There is visible swelling or experience pain from an acute injury
The skin is damaged or sensitive
You have vascular disease, diabetes, or multiple sclerosis
* Diathermy therapy is not recommended for diabetics as it can cause increased risk of burns and nerve damage. For MS patients, heat can increase symptoms (Uhtoff’s phenomenon) when core body temp rises.
If you belong to a gym that offers a sauna or a steam room, by all means take advantage of it.
Throughout the years of practice, I have treated many soft tissue injuries. Ice/heat therapy along with regular chiropractic adjustments can effectively relieve symptoms, both short and long term. Consult with your chiropractor for direction on how to safely and effectively combine different cold or heat therapies in your pain relief management. You can contact my office to make an appointment, or book online.
