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Sheltering Arms Blog

Heat vs. Ice – Which is Better?

Posted on: August 6, 2018 by Sheltering Arms

By Kimberly Johnson, PT, MSPT, OCS, Cert DN

You have pain and swelling, but should you reach for an ice pack or hot pad to find relief?

The purpose of heat or cold is to temporarily make you feel better so you can move more easily. If you’re trying to decide between cold therapy and heat therapy, consider the type of pain you have, where it is, what your doctor recommends, and what relief you personally get from each one. For instance, a review of studies on lower back pain found that heat had a slight edge over cold and that it often works best in conjunction with other treatments, like exercise, physical therapy and medication. According to the Arthritis Foundation, either heat or cold may help with pain from arthritis. It is often a matter of trial and error to find which works better for you.

Cold therapy can be particularly helpful if you have an overuse injury and a muscle or joint is swollen and painful following exercise. It may also feel best on a flaring arthritic joint. If you have a sore or painful muscle or a very stiff joint, heat therapy may be your best bet to relieve symptoms.

In general, for an acute injury, such as a pulled muscle, joint sprain or traumatic tendonitis, when swelling is noted a good rule of thumb is to use cold therapy during the acute period (first 48-72 hours), or until after swelling and pain have peaked. Thereafter, heat therapy may be more advisable as you enter the sub-acute phase (3-7 days), or for prolonged symptoms lasting beyond a week.

Possible heat treatments are a warm bath/shower, hot water bottle and moist heating pad. Heat should be comfortably warm and applied for 20-30 minutes. Use caution to avoid burns and check for extreme redness. Do not fall asleep when using an electric heating pad and remove jewelry on and around the area being heated. Pregnant women, children and people with a history of multiple sclerosis should avoid heat therapy.

Cold treatment options include the use of an ice pack made of ice cubes, commercial ice packs or a basin of cold water for hands and feet. During icing, watch for hypersensitivity or allergies related to cold indicated by increased burning or cold reactions that last longer than several minutes.