Should You Use Ice or Heat to Help with Pain?


“Should I use ice or heat to help with my pain?” is a question I receive from a variety of patients many times a week. These patients are often searching for an alternative to pain medication, which can be expensive and even addictive for some. The use of ice and heat is a cheap, usually low-risk option that can be effective for pain management. However, many patients are confused about which modality to use in different situations.

In general, ice is used to calm down swollen or inflamed tissue immediately after an injury. Swelling is your body’s natural response to injury – the inflammatory process is a healthy, normal, but often painful process that causes damaged tissue to become red and swollen. Unfortunately, local swelling can also lead to compression of nearby tissues, which causes further discomfort. Using ice, we can reduce the pain of inflammation without having to resort to drugs. Cold should only be applied locally, and it should never be used for more than 20 minutes at a time, although patients often say they ice for longer periods of time than that. Over-icing can cause frostbite, and patients with decreased sensation or neuropathy should especially take caution. Exactly how long and how often a patient should ice an injury depends on a variety of factors that a physical therapist can assess, but generally for the first 72 hours after an injury it can be iced at least 3 times per day for 10 to 15 minutes each time. After 72 hours, some people will respond better to heat, and they can try using heat to alleviate pain and promote healing.

In contrast to ice, heat should be used for muscle issues, chronic pain, and stress. Applying heat to an area of the body increases blood supply, stimulates elimination of toxins, and relaxes stiffness and soreness to bring relief. It is often used on an ongoing injury just before exercise, and it is typically more effective than ice for treating muscle spasms, low back pain, and neck pain. Heat is usually more soothing to the nervous system and the mind than ice, and it often helps relieve pain from a chronic injury. When applying heat, be sure to protect yourself from direct contact with the heating source by wrapping it with a towel to prevent burns, stay hydrated, and make sure not to fall asleep on a heating pad. Generally, heat should be applied 1-3 times a day for 10-15 minutes at a time – however, if heat is added too early in the healing process it can perpetuate the inflammation cycle and be harmful for the body.

Ultimately, the decision to use heat or ice is up to you. Your body might respond differently to heat or ice, so try different variations of both treatments to determine which ones you find most effective. If you have recently been injured and are dealing with pain, a physical therapist can evaluate you and help you to determine an appropriate course of action for treatment. Contact your local Foothills Sports Medicine’s Phoenix physical therapy clinic today if you have more questions about pain management and treatment modalities!


Jim Kostrewa

PT, MSPT | Sun City Location