Do I use heat or ice? This is a question we get all the time in clinic – and the answer changes depending on the injury, how long you’ve had pain for and personal preference.
As a rule, you should use heat for
1. Longer term injuries
2. For general stiffness/soreness e.g. post tough gym session
3. For arthritic joints
4. For spinal areas
The aim of heat is to help with pain relief and relaxation.
There are many options to choose from when it comes to heat; heat creams, packs, stick-on patches or a hot bath. For the most part the choice is a matter of personal preference and what is most convenient. For those with sensitive skin I generally recommend the heat packs or a hot bath. For people travelling or doing manual work, the heat patches and creams can be a great option. Main thing is stick to one source of heat at time; you don’t want to have a heat cream on and a heat pack at the same time.
When it comes to heat 20 minutes is enough to get some relief. If the heat feels good, you can keep going with it as much as you’d like.
Generally, look to use ice:
1. Use when there are signs of inflammation (heat, swelling, redness).
2. Best in the first 72 hours post-injury
3. Joints further away from the spine: think ankles, knees, wrists.
The main aim of the ice is to help reduce pain and to reduce inflammation and swelling.
While a lot of people get good relief from ice, there are a handful of people that find it more painful – so if you try to ice an injury and it feels sore, listen to your body. Instead, you can try heat and see if that helps with the pain relief that you are looking for.
When using an ice pack, make sure you have something between it and the skin e.g. tea towel, ice pack wrap. We recommend this cold treatment for 20 minutes and doing this 3 times a day while in the initial 72 hours post injury.
Heat and ice can also be used in combination to cause changes to blood flow in the injured area. This can also be helpful in the first 72 hours post injury, or when dealing with post-exercise muscle soreness. For this we recommend an ice-bucket for 20 minutes followed by heat for 15 minutes.
If you’re ever unsure of which to use, ask your physio at your next appointment and they’ll be able to give you more specific direction. However if you’re using either one and it helps with your pain – that’s a sign to keep going!
