Should I Use Heat Or Ice To Relieve My Pain?

ice hot therapy pain

After a joint or muscle injury, it is common to treat inflammation, swelling, and pain with cold and/or heat therapy. When is it right to use cold therapy vs. heat therapy? Can you use both on the same injury?


Ice or a cold compress is recommended for severe muscle spasms, bruising, and swelling associated with acute sprains/strains and orthopedic rehabilitation. It causes constriction of blood vessels, decreased metabolism, and decreased nerve conduction, or analgesia. Inflammation can last for a couple of days; therefore, cold packs can be applied a few times a day for several days after the injury or until symptoms improve.

  • Ice should be applied for approximately 10 min and never directly on bare skin. Wrap the compress or ice in a towel or pillowcase. Wait until the skin warms up before reapplying an ice pack.
  • Ice should not be used on individuals with Reynaud’s Syndrome or general hypersensitivity to cold.
  • Most beneficial for 48 hours after an acute injury or with recurring symptoms seen in swollen joints (rehabilitative, arthritisligament injuries, shoulder impingement/bursitis), pain management for nerve root irritation, muscle/joint pain in pregnancy.


Heat causes dilation or increased blood flow to the area of application. This aids in promoting the healing process by increasing oxygen uptake in the tissue. Heat also helps generate soft tissue extensibility.

  • Hot packs and therapeutic ultrasound are used to treat joint stiffness, muscle spasms, joint/muscle contractures, and pain. A hot pack is superficial and warms the skin and the subcutaneous layer. Two to three layers of towels are used to protect the skin. Ultrasound generates sound waves through a transducer to penetrate deeper into muscle tissue and receptors in muscle and joints.
  • Hot packs should be avoided on any areas with decreased sensation. Avoid lying down directly on a hydrocollator pack. Apply the hot pack for 10-15 min, regularly checking the skin for burns or blisters.
  • Therapeutic ultrasound is not used on individuals with a history of cancer, those who have a pacemaker, or are pregnant, but for others, it can be beneficial for degenerative joint disease, frozen shoulder, myalgia, scar tissue after surgery/trauma, and fibromyalgia.

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