Ice vs Heat – Which and when to use

Have you been questioning yourself whether or not to use topical thermal
modalities (heat or ice packs) for an injury? Have you been trying to figure out
which one is best to use for your pain?
Generally speaking, ice helps during the acute stages of an injury, and to control inflammation
and pain. Heat helps during the healing process, and to promote relaxation.
Inflammatory phase happens once an injury is new (during the first 48 hours after an ankle
sprain, for example) or once there is an ongoing overload/pressure on certain tissues (like with
severe plantar fasciitis). Pain that is associated with inflammation worsens with rest, and gets
better with movement/activities. Inflammation is many times accompanied with swelling,
excessive heat in the tissues and redness. During this stage heat is not recommended, as it
brings more blood flow to the area and worsens the inflammation. Ice however, helps with
reducing the inflammation. If the skin and sensation are intact, icepacks can be used for around
(and no longer than) 10 to 20 minuets at a time on the injured body part. Some people may
also find that Ice helps with managing their pain. That’s because the same “free nerve endings”
(in the skin) that report pain to the central nervous system, also report the “cold”. If your body
is not sensitive to cold (or if it actually prefers it over heat) you may find it beneficial to use
icepacks on the painful areas in order to have the free nerve endings report “cold” instead of
“pain”.
Once the inflammation subsides, or if an injury is not inflammatory in nature, heat is the
preferred topical thermal modality. During the healing process, the increase in the blood flow,
promoted by heat packs, brings the nutrition and oxygen that is required for healing to the
injured body part. If no other contraindications exist, heat packs can be used for episodes of 20
to 30 minuets. Many people also find using a heatpack relaxing and beneficial for treating
tightness and spasm.

If you are not sure about the safety of topical thermal modalities for your injury, or if you are
unsure about the possible treatment options for your specific injury/discomfort/pain, contact
PhysioD today for a free consultation. You may reach our clinic by phone (416.224.8484) or by
email ([email protected]).