When it comes to rehabilitation and recovery, one of the most common questions our PTs are asked is “Should I use ice or heat?” Knowing the appropriate time to use each one may be beneficial in decreasing pain and speeding up the recovery process.
How Ice Works:
Ice works by decreasing the local temperature of the tissue within your body. This results in a decrease in blood flow, swelling, muscle tone, metabolic rate, and nerve conduction. It can also help increase the body’s pain threshold. Ice can be applied for 15-20 minutes at a time. Ice should not be applied right before activity as it may decrease your performance.
When to use Ice:
- Abnormal tone
- Acute or chronic pain
- Acute or subacute swelling
- Bursitis
- Muscle spasms
- Musculoskeletal trauma (sprains/strains/bruising)
- Tenosynovitis
Use caution with application of ice for people with cardiac failure, hypertension, infected tissues, and damaged or at-risk skin. It should not be used if you have an active DVT, near chronic wounds, open wounds, cold hypersensitivity (Raynaud’s, cryoglobulinema, hemoglobulinemia), cold urticiaria (cold allergy or hypersensitivity), impaired circulation, or over regenerating nerves.
How Heat Works:
Heat works by increasing the local temperature of the tissue within your body. This results in an increase in blood flow to the area, capillary permeability, collagen extensibility, metabolic rate, nerve conduction velocity, and pain threshold. Heat can be applied for 15-20 minutes at a time. Be sure to perform skin checks frequently to prevent burns.
When to use Heat:
- Abnormal tone
- Arthritis
- Decreased range of motion
- Muscle spasms/cramps
- Muscle/joint stiffness without swelling
- Myofascial trigger points
- Subacute or chronic pain
Heat should not be used for people with arterial disease, bleeding or hemorrhage, peripheral vascular disease, thrombophlebitis, over cancerous areas or within 24-72 hours of muscle/ligament/tendon trauma.
After looking at all the benefits of using ice and heat for injuries, here are some easy-to-remember rules to pick your proper modality.
- If the injury is new and has occurred within the last 3 days = Ice
- If there is noticeable swelling = Ice
- If you have no significant swelling and decreased range of motion = Heat
- If you have increased muscle tightness, spasms, or trouble relaxing muscles = Heat
If you have had pain for an extended period of time with no range of motion loss and significant
swelling = Ice first, then Heat
Want to find more ways to reduce pain and injury? Make an appointment with one of our Doctors of Physical Therapy here!
