My clients will often ask me what is better…heat or ice? The answer is, it depends! They both could be effective in decreasing the pain.
Cold is typically most effective in the “acute phase”, which is the first few days following an injury. This is the period when the muscles are typically most inflamed and swollen. Due to that inflammatory response the first few days following injury, the ice will be most effective calming down the inflammation and push out any swelling from the injured area. I typically recommend placing an ice pack to the painful area for approximately 15 – 20 minutes as needed (up to once per hour).
Heat is most effective in the “chronic phase” of an injury. This is when the injury has been persisting for several weeks to months following the initial onset. During this phase the muscles are typically guarded and tight. Therefore the heat will be most effective with loosening those tight muscles and ease your pain. I recommend applying heat to the painful area no greater than 10 – 15 minutes. When using heat it’s important that you be very careful not to burn yourself, especially for those of you who have loss of sensation, which is common for people dealing with injuries to the back and sciatic nerve and for those with neuropathy.
So there you have it, use cold right when the injury starts and heat several weeks after injury. However, some of you may be asking what do I do in between. Well, this time period is what we call the “subacute phase”, and the answer is it depends. It depends on your symptoms and how you present. If you have more swelling & inflammation then apply ice. If you have more stiffness/tightness then heat may be more beneficial. I typically recommend heat in the morning, which is when we tend to be stiffness after lying in bed all night, and using ice in the evening, after you been active throughout the day and your muscles will most likely be sore and inflamed.
Best practice is to always make sure to consult with your physician or healthcare professional prior to initiating any new treatment interventions or if you have questions.
(Disclaimer: The information contained in this article is presented for the purpose of education only. Nothing contained in this report is intended to be instructional for medical diagnosis or treatment.
The information should not be considered complete, nor should it be relied on to suggest a course of treatment for a particular individual. It should not be used in place of a visit, call, consultation or the advice of your physician or other qualified healthcare provider. Information obtained in this report is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. Should you have any health care related questions, please call or see your physician or other qualified healthcare provider promptly. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of something you have read in this report. )
By Dr. Ken Corcoran, PT, DPT, SCS, CEAS