Heat or Ice? When to Use Heat or Cold for Injuries

When to Use Heat or Cold for Injuries?

The quick answer is to use heat for sore muscles, chronic pain, and stress. Use ice/cold for actual injuries, swelling, redness, or acute pain resulting from a twist or heavy impact.

Determining when to use heat or cold for injuries can difficult if you are not schooled in the science behind heat and cold/ice and how they affect the body.  To read more about this subject, please go to when should I use heat or ice.

Use heat for sore muscles, chronic pain, and stress. Use ice/cold for actual injuries, swelling, redness, or acute pain resulting from a twist or heavy impact.When to Use Heat or Cold for Injuries

How it Works: Why Heat for Chronic Pain and Why Cold for Acute Pain and Injuries?


Heat is better for chronic pain or stress-related pain because it:

  • Increases oxygen flow and nutrients to the muscles, helping to heal damaged tissue.
  • Stimulates sensory receptors in the skin, which reduces pain signals to the brain and partially relieves discomfort.
  • Helps eliminate toxins.
  • Relaxes stiffness.


Cold is better for injuries because it:

  • Reduces swelling by constricting local blood vessels and decreasing tissue temperature, leading to significantly decreased blood-flow and significantly slower cell metabolism.    
  • Numbs pain via numbing of the nerve receptors from the decreased blood flow.

Tips on Applying Heat to an Injury

Heat therapy helps with back painHeat therapy helps with back pain.


There are two types of heat therapy:

Local heat involves heating a specific spot on your body using a warm cloth, a heating pad, or a heated gel pack.

Systemic heat means raising your entire body's temperature via a bath, jacuzzi, steam bath, or hot shower.

When applying heat therapy, it's key to:

1. Keep the heat source 'warm' not 'hot.'

Your heat source shouldn't be burning your skin. Remember, the desired effect is penetration into the muscles. Scalding yourself will not accomplish this.

2. Not apply the heat for too long or too short.

In many cases, the longer the heat is applied, the better. However, the heat application duration should be based on the type and/or magnitude of the injury.

For something like minor back tension or pain, a short interval of heat therapy (such as 15 to 20 minutes) may suffice. For more intense or painful injuries, longer application of heat (such as 30 minutes to 2 hours, or evermore) may work better.

It also depends on how patient you are and how willing you are to sit still. If sitting still and/or reading or watching TV isn't an option, know that there are many different types of heat wraps, many of which are made to stay on while moving.  Also, the best heat wraps will maintain their temperature for a long time.

If you're sensitive to heat, the amount of time you apply the heat should be shorter. You may also need to use a barrier and/or wrap the hot pack in a towel before applying if it's too hot.


Tips on Applying Cold to an Injury


Cold or ice therapy should only be applied locally and should never be applied for more than 20 minutes at a time,

Remember: you're not looking to induce hypothermia; you're looking to numb your pain and restrict blood flow to the injury.

Also - if you're extra sensitive to cold, you should decrease your time.

Cold therapy can be applied via:

  • An ice pack
  • A cold gel pack
  • A bag of frozen vegetables
  • A frozen towel
  • An ice massage
    For an ice massage, using an ice cup will produce the desired effect in less time. You can buy plenty of ice cups, or you can make it at home by simply putting ice in a plastic cup and freezing it. Place the ice cup directly on the injury and massage the injury with the cup. Ice massage therapy is commonly used for things such as minor lower back pain.

Use ice/cold for actual injuries, swelling, redness, or acute pain resulting from a twist or heavy impact.Use ice immediately following an injury.

  • Make sure your skin is dry before applying.

Applying ice or cold to wet skin will increase frostbite chances, so always make sure your skin is dry.

  •  Get it on quickly.

The effectiveness of cold therapy is highest immediately after injury and declines significantly after about 48 hours.

  • Elevate the injury.

Keeping the injured part above the heart while icing will help reduce swelling even more.

  • Count the minutes.

Be sure not to apply the ice for more than 20 minutes, or you could be risking frostbite.

To schedule physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.


If your injury requires physical therapy or a doctor evaluation, visit JOI.net, call 904-JOI-2000,.or click below.




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