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Ice or Heat Therapy: Which Do I Use?

heat ice back pain
Heat and Ice Therapy

Perhaps you woke up one morning, and your neck was stiff, or you overdid it at the gym, and your knee was swollen. Should you use ice or heat to help?

If you decide to treat a condition like this at home before calling a doctor, you might be confused about which method to use.

Understanding when to use heat or ice is crucial to healing because they have opposite reactions in the body.

So which one should you use?

  • Looking to relax muscles? Say YES to Heat!
  • Trying to reduce swelling and inflammation? Say NO to Heat!
  • Looking to relieve swelling and inflammation? Say YES to Ice!
  • Have muscle spasms? Say NO to Ice!

The Heat is On!

Heat treatment relieves stiffness, chronic aches, facilitates relaxation, and stimulates circulation.

Heat treatments should be used for:

  • Chronic injuries or injuries that have no inflammation or swelling
  • Tight or spasming muscles or muscles containing trigger points
  • Chronic injury, sprain or strain
  • Arthritis pain
  • Sore, stiff, nagging muscle or joint pain

How to Apply Heat:

  • Place a washcloth under hot tap water or heat it up slightly in the microwave, and then apply it directly to the injured area
  • Use heating pads, paraffin wax treatments, heat wraps or whirlpools
  • Never leave heating pads on for more than 20 minutes at a time or while sleeping
  • When an injury is older than 48 hours, heat can be applied in the form of heat pads, deep heat cream, hot stones, hot water bottles or heat lamps

Heat Tips:

Your goal should be to warm, but not overheat the area. Treat with heat for no longer than 20 minutes and make sure to wait 1 hour between heat treatments.

Ice, Ice Baby!

Cold therapy is the treatment of choice for acute injuries that have occurred within the last 72 hours.

Cold therapy should be used for:

  • Inflammation/swelling relief
  • Numbing pain
  • Circulation stimulation in areas of chronic discomfort
  • New injuries
  • Newly aggravated muscles or tendon strains
  • Ligament strains
  • Soft tissue or bone bruises

How to Apply Ice:

  • The best way to ice an injury is with a high-quality ice pack that conforms to the area that is being iced.
  • The effect of the ice pack is thought to be improved if it is pressed gently onto the injured area.
  • Another method of icing is ice massage.  Freeze a paper or Styrofoam cup full of water, and then tear off the top rim to expose the ice. Move the ice continuously over the injury for 15 minutes.

Ice Tips:

Ice is typically used within the first 48 hours after an injury such as joint sprains or muscle strains. You can apply ice several times a day for 20 minutes at a time. Taking at least a 20-minute break in between.

Do not leave the ice on for more than 20 minutes, or you can do more harm than good.


  • A cotton tube sock and rice can be used for both a hot pack and cold compress.
  • Fill a cotton tube sock ¾ of the length with plain white rice, beans, flax seeds, cherry pits or oats, and sew or tie the end shut.  Heat this in the microwave on a plate (to keep the sock clean) for 2 minutes. Or, for a cold compress, place in the freezer for a few hours.
  • Ice packs can be made from ice cubes in a plastic bag or wet towel.
  • A bag of frozen peas is also ideal. The frozen bag molds nicely to the injured area and can go in and out of the freezer.
  • Grab a Ziploc bag and a big bottle of cheap liquid detergent. Fill the Ziploc bag ½-¾ full with liquid detergent, remove as much air from the bag as possible and place in the freezer. The detergent doesn’t solidify making it easy to mold around the injured area.
  • Got a little boo-boo that doesn’t require a large ice pack? Freeze condiment packets for a mini ice pack. They are small enough for little hands to hold and oh…they’re  free!

Need Help?

Modoma is a medically directed health and wellness clinic providing physical medicine and rehabilitation. We combine the benefits of massage with the medical practicality of physical therapy.
4944 Preston Rd, Ste 100A
Frisco, TX 75034
(972) 861-1143