Heat vs. Ice – Which is Better for Your Pain?

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

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Are you experiencing pain or swelling, but you’re unsure if you should reach for an ice pack or a heating pad to find relief? The purpose of heat or cold therapy 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, ask yourself the following questions:

  • What type of pain do you have?
  • Where is your pain located?
  • What does your doctor recommend?
  • What relief do you get from each temperature?

Conditions where cold therapy works best

  • Cold therapy can be particularly helpful if you have an overuse injury like shin splints or tendinitis. It’s also appropriate for swollen muscles or joints following exercise.
  • Cold therapy may also feel best on a flaring arthritic joint.
  • For acute injuries like pulled muscles, joint sprains, or traumatic tendonitis where swelling is noted, a good rule of thumb is to use cold therapy for the first 48-72 hours after swelling and pain have peaked.

Conditions where heat works best

  • For low back pain, heat therapy has a slight edge over cold therapy. It often works best in conjunction with other treatments such as exercise, physical therapy, and medication.
  • If you have a sore or painful muscle or a very stiff joint, heat therapy may be your best bet to relieve symptoms.
  • After the first 48-72 hours of using cold therapy for acute injuries like pulled muscles, heat therapy may be more advisable as you enter days 3 through 7, or for prolonged symptoms lasting beyond a week.

Conditions where heat or cold may work best

According to the Arthritis Foundation, heat or cold may help with arthritis pain. It is often a matter of trial and error to find which works better for you.

Examples of heat treatments

Possible heat treatments include a warm bath or shower, a hot water bottle, or a 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. Women who are pregnant, children, and people with a history of multiple sclerosis should avoid heat therapy.

Examples of cold treatments

Cold treatment options include 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 the cold, indicated by increased burning or cold reactions that last longer than several minutes.

If your pain persists, it might be time to seek a medical professional. At Sheltering Arms Institute, our therapists can provide a tailored treatment program specific to your needs. To schedule an evaluation, contact us online or call (804) 764-1000.

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