Heat or Ice? By: Victoria Lavery PT, DPT
One of the common questions we get as physical therapists is whether to use heat or ice following an injury. The answer to this is not always clear, as it depends on multiple factors including the acuity of the injury and often personal preference. Typically, ice is used for acute injuries to reduce pain and swelling, and heat is used for muscular and chronic pain, but this can vary from person to person.
Heat and cold therapy have different effects on our bodies to produce different results. The physiological effects of cold therapy include reduced pain, reduced blood flow, reduced swelling, and reduced metabolic demand. However, there has been limited evidence to support the use of cold therapy following acute musculoskeletal injury. On the other hand, the physiological effects of heat therapy include pain relief, increased blood flow, increased metabolism, and increased elasticity of connective tissues. For this reason, heat should not be used on areas of swelling because it increases blood flow to the area which can increase swelling. However, evidence has shown that heat therapy is effective to provide short-term reductions in pain for those with acute low back pain and delayed onset muscle soreness (DOMS).
The effects of heat and ice vary from person to person, and they also vary depending on the particular condition. For example, those with arthritis may utilize heat to ease stiff joints and reduce muscle tightness. For individuals with gout, ice can calm flare-ups and reduce pain. For strains and sprains, ice can help initially to reduce inflammation and pain, but heat can be helpful later on to reduce stiffness after inflammation resolves. In the case of tendinitis, ice can ease irritation and pain, and for tendinosis heat can aid in reducing stiffness after inflammation resolves. With either, caution should be used on areas of reduced sensation. Looking at both options, there is still a need for more research to be done to determine which is best, but the choice to use ice or heat is often determined by personal preference, as each person may respond to each a little differently. It can often take trial and error to figure out which one works best for you!
If you have any questions or would like to schedule an appointment please contact us at Advanced Rehabilitation!
References:
Bone, Muscle and Joint Team. “Should You Use Ice or Heat for Pain? (Infographic).” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 30 July 2020, health.clevelandclinic.org/should-you-use-ice-or-heat-for-pain-infographic/.
“Schedule Your Appointment Online.” When to Treat Pain with Ice vs Heat, www.piedmont.org/living-better/when-to-treat-pain-with-ice-vs-heat.
J;, Malanga GA;Yan N;Stark. “Mechanisms and Efficacy of Heat and Cold Therapies for Musculoskeletal Injury.” Postgraduate Medicine, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/25526231/.
Ambardekar, Nayana. “Heat and Cold Therapy for Arthritis Pain.” WebMD, WebMD, 21 Jan. 2020, www.webmd.com/arthritis/heat-and-cold-therapy-for-arthritis-pain.