Heat Vs Ice For Pain - Which is Better?

Hot and cold therapies are some of the easiest and cheapest ways to treat pain at home, but there is often confusion as to which therapy is best for which situation. Let’s take a quick look at the benefits and risks of both hot and cold therapy and when to use each.

Heat therapy works by increasing the temperature of the tissue, thereby causing vasodilation and increased blood flow to the heated area. It can help to relax sore, tight muscles and reduce pain in aching joints. Moist heat from a bath, hot towel, hot water bottle or moist heating pack is the most effective. Heat is best used for chronic pain or older injuries and should be applied for about 20 minutes. Heat should not be applied to open wounds or to areas that are bruised or swollen as it will exacerbate these conditions.

Cold therapy (cryotherapy) works by cooling the tissue, thereby causing vasoconstriction and decreased blood flow to the cooled area. This helps to relieve swelling due to injury. The cold can also have a calming effect on the nerves. Cryotherapy is best applied using a frozen gel pack wrapped in a thin towel. Never put ice directly against the skin as it can cause damage. It is best to ice several times a day for no more than 20 minutes, allowing one hour between each session so that the tissue can warm up again. Cryotherapy should be used for new (acute) injuries and for any inflammation or swelling.

So, if heat relaxes muscle tissue and ice reduces swelling, what should you do if you injure a muscle? The first therapy that you should reach for in that case is ice. Ice for several days or until the pain begins to feel less sharp and more achy. You can then try heat for no more than 15 minutes at a time. If heat makes symptoms worse, return to ice.

And what about after a deep tissue massage? As many of you know, I usually recommend ice immediately after a massage. This is because deep tissue work often elicits an inflammation response from the body and, while I always try to avoid causing any bruising, it does sometimes occur. Ice helps to calm the body after deep tissue work, helping you feel better faster. There are certain times when I will recommend a hot bath followed by ice after a massage, but that is not appropriate in all cases. When in doubt, ice! And remember that you can always reach out to me if you have any questions about your post massage self care.