Ice vs. Heat — Which is Better?


Working in rehabilitation services, our physical therapists are often asked which is more appropriate to use, ice or heat? The short answer to the question is: it depends. It depends on the situation, and more specifically, the time frame since your injury and/or onset of pain. To best understand whether ice or heat is appropriate, we need to know the body’s physiological response to each one.


The Mechanics of Icing Injuries

Let’s first talk about cold therapy. It may feel good to ice your aches and pains, but is it the right option? A cold stimulus like ice will cause vasoconstriction of the vessels in the area that you are addressing. This means the vessels become more narrow, which limits the amount of blood flow the vessels can bring to the area. This is most beneficial in the acute stage of an injury. 

When you are initially injured, the trauma of the injury can lead to uncontrolled swelling. Swelling, while a normal part of the healing process, can be a significant contributor to pain, delayed healing, and additional tissue damage. By applying ice to an injured area, we can minimize the amount of swelling that occurs, therefore limiting pain and improving healing time. 

Cold therapy from ice or ice packs can also be beneficial after periods of increased activity and/or exercise, as this is when more blood flows to the injured/painful area, increasing discomfort. Ice is best utilized in 15-20 minute increments to reap the most benefit. 


Using Heat for Pain and Tissue Mobility

Now let’s discuss the impact of heat therapy. As you would expect, a warm stimulus will do the opposite of cold, causing vasodilation. In other words, heat opens the blood vessels. As the vessels open, more blood can flow into the affected area. 

Blood flow is an essential part of healing. With more blood flow, tissues become more mobile, bringing essential nutrients to the area, and promoting relaxation of the tissues. Heat therapy is best used after the acute stage of an injury, typically around 2-3 days post-trauma. Heat is also recommended for subacute and chronic pain situations, when pain has occurred for 2-3 weeks or more. 

The more restricted the movement of a tissue is, the more likely it is to cause discomfort. When heat is applied and tissue mobility improves, this often helps to improve pain as well. That said, you are certainly not limited to the use of heat for chronic pain. In these cases, we often recommend trying both modalities to see if you find more benefit from one versus the other, as it can vary from person to person. 


Both Ice and Heat Have Healing Benefits

In summary, both ice and heat provide benefits to help manage pain and enhance recovery from an injury. It is valuable to understand how each modality impacts your body so you can best determine when each one is appropriate. Everyone is unique and may respond differently to ice or heat. Ultimately, outside of the acute phase when ice is recommended, do what feels best for you! 

If you have an injury, contact Balanced Fitness & Health for personalized physical therapy. Our caring therapists will guide you on the use of ice or heat as well as stretches and exercises to speed your recovery! Make your appointment now!