I cannot tell you how many times a day, as a PT I get asked if a patient should heat or ice. They get mixed advice which makes the decision even more confusing! So, let’s get into the science behind what heat and ice do to the body.

Ice DECREASES blood flow to the injured area which reduces swelling, inflammation and controls the pain. So, when should ice be used? Right after an injury and up to 72 hours following. Apply cold pack for no more than 20 minutes and perform skin checks every 5 minutes to ensure there is no damage to the skin. 

Heat INCREASES blood flow which promotes relaxation of the muscle, can increase range of motion and helps alleviate pain. So, when should heat be used? No sooner than 72 hours after an injury, chronic pain and to help loosen up tight joints and muscles. Use for no more than 20 minutes at a time with frequent skin checks. 

Examples: Arthritis, use heat. Gout flare-ups, use ice. Headache, ice can reduce the throbbing head pain and heat can help reduce muscle spasms in the neck. Strains and sprains (pulled muscle/ligaments), ice eases inflammation initially and heat eases stiffness after the inflammation resolves. Tendonitis (acute), use ice. Tendinosis (chronic), use heat. Chronic back pain, use heat. Fibromyalgia, use heat. Before exercise, use heat. After exercise, use ice.