• Corinne Mclardy Smith


One of the questions I get asked a lot when people are in pain is when to use heat and when to use ice.

The general rule of thumb is to use ice for acute pain and heat for muscle stiffness/aching and some chronic health conditions. But remember, both ice and heat can cause skin burns if used excessively or inappropriately.

Ice for pain

Acute pain has 3 categories;

  1. Acute: 0-4 days

  2. Sub-acute: 5-14 days

  3. Post acute: after 14 days

Acute pain is classified as a new injury or pain, or a new 'flare-up' of a pre-existing injury. It is often associated with:

  • Inflammation/swelling

  • Heat around the affected area

  • Redness and/or bruising

  • Loss of mobility/function.

Ice helps by constricting the blood vessels around the area of the injury therefore reducing the blood flow. This in turn helps to reduce inflammation/swelling, heat and subsequently can reduce the pain.

With an acute injury the quicker you can get ice on the more effective it is, usually within the first 24-48 hours.

Ice should only be applied for short periods of time ideally for 10 minutes and no more than 15 minutes. Ice should never be placed directly on the skin always making sure the ice is wrapped in something e.g a cloth/tea towel.

When not to use ice:

  • Stiff muscles/joints due to ice reducing blood flow.

  • Any sensory disorders as patient may not be able to tell if the ice is on for too long and risk burning the skin (seek GP/Doctors advice for more info)

  • Cardiovascular disease (seek GP/Doctors advice for more info)

  • Heart disease (seek GP/Doctors advice for more info)

  • Poor circulation again due to ice reducing blood flow.

Heat for pain

Best used for:

  • Muscle aching or stiffness.

  • Cramping muscles, or cramps such as period pains.

  • Some chronic illness' such as arthritis and fibromyalgia (seek GP/Doctors advice before using heat on any chronic illness)

(N.B Heat can be beneficial for rheumatoid arthritis to help ease aching muscles, but it is generally advised to not use heat on swollen or hot joints, ice in this case is usually better. Here is a link that goes into more detail.

Using Heat and Cold to Treat a Rheumatoid Arthritis Flare-Up (arthritis-health.com))

How heat helps:

Heat improves circulation and the blood flow to the affected area. This means an increase in oxygenated and nutrient rich blood. Therefore this helps to improve healing and also reduce lactic acid build up in overused/overtaxed muscles. The effect of this is the relaxation or 'easing-off' of tight or painful muscles.

Heat can also help to heal damaged tissue once past the acute phase.

You can use heat for longer than ice. For minor tension/stiffness then apply heat for around 15-20 minutes. More moderate to severe pain/stiffness then you can apply heat for 30 minutes or more, even up to a couple of hours e.g a hot bath.

The same rule applies with heat as with ice, do not apply heat directly to the skin make sure that it is wrapped in something before applying it to the skin.

When to not use heat/or to seek medical advice prior to using:

  • Diabetes

  • Dermatitis

  • Vascular disease

  • Deep vein thrombosis

  • Infection

  • A new injury if there is bruising or swelling or on an open wound. This is because of heat increasing the blood flow to the area.

Hopefully this blog has helped to explain a bit about when to use ice and heat and why.

Bellow are a couple of links that go into a bit more detail if you wish to know more.

Any further questions please do not hesitate to get in touch.

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