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Heat vs. Ice: Should I Use Heat or Ice for Pain?

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Updated April 16, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Heat vs. Ice: Should I Use Heat or Ice for Pain?
Answer: Some people insist that heat is the best thing for pain, while others tell you to ice it. How do you know which one to use? Here is a simple guideline for determining which one to try.

When to Use Heat for Pain

Before using heat, ask yourself the following questions:

  • Has your injury healed?
  • Are your muscles tight and tender?
  • Is your pain located in your joints or muscles?
Heat can be an effective form of pain relief if muscle tension increases your pain. It can also help "loosen" stiff joints. This makes it appropriate for musculoskeletal conditions, such as arthritis and old muscle strains or sprains. However, heat is not effective and may be detrimental for cases of acute pain caused by new injuries. Heat should also not be used over broken or damaged skin, or over areas with cancerous tumors.

When to Use Ice for Pain

If your injury is new, ice may be the answer. Ice can help to decrease swelling and bleeding, and can reduce bruising caused by trauma. Ice isn't only for new injuries, however: it can numb sensitive areas and decrease pain sensations caused by chronic conditions as well.

Ice can be an effective pain reliever for many chronic pain conditions, including:

A Little of Both? Combining Ice and Heat Treatments for Pain

In our therapy clinic, we often use both heat and ice to treat pain, with a little exercise in the middle. You can apply heat to a muscle to warm it up, stretch and strengthen it, and then finish it off with a little ice to cool it down. It's not exactly a spa treatment, but it helps many of our patients tolerate the exercise that will benefit them.

Sources:

Belanger, Alain-Yvan. "Evidence-Based Guide to Therapeutic Physical Agents" Philadelphia: Lippincott Williams & Wilkins 2003

Gould, Harry J. "Understanding Pain: What it Is, Why it Happens and How It’s Managed" New York: AAN Press 2007

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