Ice vs. Heat: A Guide to Hot and Cold Therapy for Pain

Many people know that the recovery of pain or injury can be expedited by using hot and cold therapy. If a hammer catches your thumb or you get a bad bruise from a bike collision, you may have put frozen peas or a bag of ice on the injury. If your joints are achy from the flu, someone may have suggested you take a hot shower. What many people don't understand is why they ice vs. heat and in what other applications hot or cold therapy can be useful.

Cold Therapy for Pain

Cold should be applied when you wish to reduce swelling or a strong pain on an acute injury. The reason behind the swelling of any injury is too much blood is flowing to that spot. Cold is a vasoconstrictor, meaning it causes your blood vessels to narrow. The narrowed blood vessels make it so that blood cannot flow, restricting internal bleeding and reducing the swelling. Using cold therapy for pain relief is also effective because it slows the release of chemicals that cause the pain and inflammation. The cold further reduces the ability of the nerve endings to impulse decreasing the pain you are suffering.

When should I ice an injury?

• When your doctor or physical therapist advises you to do so.
• For the immediate treatment of acute sport injuries.
• For overuse injuries or chronic pain. For example, a runner might apply cold to an achy knee AFTER a run.
• Injuries that demonstrate swelling or inflammation.
• In post-operative instances when explicitly advised by your doctor to do so.

When should cold therapy NOT be applied?

• On an open wound.
• Before intense physical activity as it may increase the likelihood of further injury.
• If you suffer from Cold Hypersensitivity, including Cold Urticaria (Hives that are aggravated when cold), Cold Erythema (a rash that arises when cold) and Cold Hemoglobinuria (where red blood cells break down as the result of cold temperatures).
• If you have been diagnosed with Raynauds Phenomenon as exposure to cold may aggravate symptoms.

One way to ice an injury is to use an ice pack or ice wrapped in a thin towel and apply it on the affected area for 10-15 minutes at a time. It is unwise to apply ice directly to the wound or sore, as this can cause frostbite to your skin cells. After applying the cold therapy for 10-15 minutes, let your skin return to a normal temperature and reapply the cold. You should do this multiple times a day for no longer than 3 days. One way to get the best results from cold therapy is to use a cold therapy unit or cold therapy wraps.

Hot Therapy for Pain

Heat is a vasodilatation and causes blood vessels to expand increasing blood flow and circulation to particular areas. This is why it is not advised to apply heat to a swollen or recent injury, as this will likely cause swelling to increase. In the ice vs. vs. heat debate, heat is best when used for a chronic pain. Heat can be used for stiff or sore muscles that have not necessarily been injured, but experience pain regularly. Another opportune time for using heat therapy is for stiff joints caused by arthritis, old age, or cold weather. When administered correctly, heat also relaxes muscle and joint tensions. Many athletes use heat therapy for problem areas before a workout as the heat increases joint tissue elasticity and stimulates blood flow.

When is heat therapy a better option than cold therapy?

• Chronic injuries or pains that do not feature inflammation or swelling. In some instances, an athlete might use heat on a problem muscle area BEFORE exercising.
• To relieve muscle or joint pain that does not feature significant swelling.
• On tight muscles or muscle spasms.

You can administer heat several ways. The easiest is using a moist heat pad. This can be applied directly to the area and should be left on no more than 20 minutes at a time. Be mindful not to burn your skin or leave a heat pad on too long or while sleeping.

Using a Combination of Hot and Cold Therapy for Pain

Treating injuries isn't always a question of ice vs. heat, however. A great way to alleviate pain is to alter hot and cold treatment. This should be done once swelling has stopped, usually 2 days after the injury. Combing hot and cold therapy works together to move blood out of the affected area. This should not be done for the whole body, but rather it should be used on the extremities or isolated areas.

It is important to start and end every session with cold therapy. Each period of hot and cold treatment should last 3-5 minutes. Generally 3 periods of cold and 2 periods of heat are administered in an alternating fashion. The entire treatment should last between 15-25 minutes. You should not apply hot and cold therapy more than once a day, but it can be done for as long as necessary. It is important to use particular care when administering heat as to prevent burning of the skin. Hot and cold therapy systems are a common and simple way to self-administer the therapy.

About MMAR Medical: MMAR Medical Group Inc. is a premier supplier of high quality medical products including a wide selection of cold and hot therapy systems, and injury solutions including braces and wraps.