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Should you use heat or ice for pain?

25th May, 2017

Hot water bottle, heat pack for painfrozen peas for pain relief

It’s a very common question! Generally it’s recommended that heat works best on aching muscles and chronic pain and ice is applied to early injuries when the area is hot and swollen.

That said, it’s often down to personal preference because either or both might help. This blog post outlines some of the similarities and differences to help you to decide.

Thermotherapy (heat treatment)

If you experience some pain relief after a hot shower in the morning, then it’s likely that using a heat treatment during the day will be helpful to you.

Heat can be applied in many different ways. It could be a hot shower, a self-heating stick-on patch, a hot water bottle or a wheat bag. It doesn’t matter how you achieve the heat, as long as you don’t cause a burn (15 minutes is a good guide).

Heat therapy works by increasing blood flow to the area. The increased blood flow washes away any chemicals that have built up, relieving pain. Heat also helps improve flexibility in the muscles, tendons and ligaments (soft tissues) to relax tight muscles and make stiff joints move more comfortably.

This soothing effect lasts for a short period afterwards and it’s an ideal time to practice some gentle stretches and exercises.

If you have a fresh injury and the area is very hot and swollen, you should avoid putting heat directly onto the injury as this will increase the swelling and make the problem worse.

Cryotherapy (ice treatment)

Ice is often recommended when an injury is fresh, hot or swollen.

The cooling effect initially decreases blood flow. This helps limit bleeding within the tissues if it’s applied immediately after an injury. Ice should only be applied briefly at this stage – no longer than 5 minutes. Any longer and the opposite starts to happen – your blood flow actually increases, which isn’t helpful in the first few hours.

After 4-6 hours have passed, the bleeding within your tissues will have probably stopped. At this stage, then ice can be applied again to dull nerve activity and relieve pain. You can keep the ice pack on for up to 20 minutes (until the skin becomes pink). You can actually repeat this stage several times over the course of a day to relieve pain and excessive swelling.

If you are using an ice pack it’s best to use something that can be moulded to your skin, like a reusuable gel pack or bag of frozen peas.

Make sure you wrap your ice pack in a plastic bag or wet towel to prevent direct contact with your skin. Keep checking and as soon as the area feels numb or has turned pick, remove the pack to avoid an ice burn. If you need to ice your foot, ankle or hand you might find it easier placing some ice cubes in a bowl of cold water to immerse the whole area.

A few precautions…

There are some exceptions to the above advice, which is why it can be down to personal preference.

For example, some chronic back or neck conditions might be better relieved by using ice compared to heat. On the flipside, a swollen knee caused by a flare-up in osteoarthritis will sometimes respond better to heat than ice.

So the take-home message is that it’s fine to try heat or ice for pain relief and see which works best for you. But remember that timings are important whichever you use. If you are using heat then 15 minutes is a good guide and if you’re using ice, apply immediately after the injury for no longer than 5 minutes, then wait for between 4-6 hours and the apply for up to 20 minutes (you can repeat this second stage up to three times a day).

As always, please give us a call if you have any questions,

The Pilatesfit Team!