Accessibility View Close toolbar

Should I Use Heat or Ice for Pain?

Ankle treated with ice

Should you use heat or ice on your painful injury? The best method of solving this important riddle is to assess the nature and source of the pain. Essentially, a new injury, that is, one that you sustained within the last 48 hours, is best treated with ice. Chronic pain, or pain that you have had for a long time, is generally best treated with moist heat. Understanding the mechanisms of injury and the physiological and biochemical causes of pain helps us to differentiate the indications for applying ice or applying moist heat.

The primary rule is that you can never go wrong with applying ice. Ice calms things down and, although an ice application may be uncomfortably cold for a few moments, the overall effect is soothing. Cold decreases local metabolism and constricts small blood vessels (arterioles). Cold reduces nerve conduction velocity, that is, the speed at which nerve impulses are transmitted, and therefore reduces the number of pain signals that reach your brain per unit time. Thus, ice applications provide vasoconstriction, analgesia, and sedation. Ice is indicated for acute musculoskeletal injury, burns, insect bites, bleeding, and snake bites. Ice should not be used for gout, rheumatoid arthritis, Raynaud's phenomenon, history of vascular impairment, and cold allergies. As well, ice should not be used for a patient in a coma.

Moist heat increases local metabolism and dilates small blood vessels. Vasodilation results in increased nutrition, increased activity of white blood cells (phagocytosis), and increased removal of waste (metabolic end-products and damaged cellular structures). Moist heat provides analgesia, sedation, and reduces muscle spasms. Heat is best for chronic pain and muscle spasms. Contraindications to moist heat include acute musculoskeletal injury, area of diminished sensation, acute skin conditions, pregnancy, malignancy, diabetes, encapsulated swelling, hemorrhagic disorders, and suppurative conditions.

Generally, ice applications are used for acute injuries within a 72-hour time frame from the onset of the injury. Acute injury damages local capillaries, causing blood to leak into the spaces between cells and tissues, where it doesn't belong. Such uncontained blood causes pressure on local nerve endings, creating pain. Also, pressure is applied to nearby cells, causing extended injury and possibly cell death. Thus, limiting the amount of blood leaking out of disrupted capillaries is critical in slowing the effects and reducing the impact of musculoskeletal injury. Ice performs this function. Ice reduces swelling, reduces pain, and provides a sedative effect.

When applying ice, it's very important to avoid damaging the skin. Ice packs should always be wrapped in a towel. Ice should rarely be applied directly to the skin. Duration and frequency of ice applications is not an exact science, but a useful guideline is to apply ice for 15 minutes every two hours for a moderately acute injury, using three to four ice applications per day. However, you will know instinctively when the time is right to apply the next ice pack.

Moist heat applications follow similar guidelines. Dry heat should never be used. Moist heat packs should be wrapped in a towel and are applied for 15 minutes every two to three hours, up to several applications per day.

Recovering from injury requires your body to put forth a great deal of effort and requires support from the nerve system, the body's master system. Regular chiropractic care provides great assistance in the process of recovery from any injury. By detecting and correcting spinal misalignments and sources of nerve interference, regular chiropractic care helps ensure optimal functioning of the nerve system. Thus, regular chiropractic care helps facilitate your recovery and helps you return to your full range of activities as quickly as possible.

1McCarberg B, D'Arcy Y: Options in topical therapies in the management of patients with acute pain. Postgrad Med 125(4 Suppl 1):19-24, 2013

2Piana LE, et al: The Cold, Hard Facts of Cryotherapy in Orthopedics. Am J Orthop (Belle Mead NJ) 2018 Sep;47(9). doi: 10.12788/ajo.2018.0075

3Mayer JM, Mooney V: Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Arch Phys Med Rehabil 87(10):1310-1317, 2006


Sign up using the form below or call us at (206) 925-3556 to make your appointment.

Office Hours

Our Regular Schedule

Seattle Total Health

Monday:

10:00 am-6:00 pm

Tuesday:

7:00 am-3:00 pm

Wednesday:

8:00 am-6:00 pm

Thursday:

7:00 am-3:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Location

Find us on the map

Testimonial

  • "A few months ago I started going to see Dr. Christie. She is amazing she did not make me feel bad for not seeing a chiropractor earlier. She went over in detail my x-rays and explained my issues. Dr. Christie takes her time going over what she is doing before she adjusts me."
    Ralph S. Seattle, WA
  • "Dr. Tiffany Christie is my first chiropractor, and I am quite content about making her my last. She takes the time to understand my needs and develops a personalized treatment plan to reach my goals! She makes every visit a treat - she is personable, professional, and passionate about what she does! Her infectious smile, awesome staff, and pain relieving adjustments have me leaving feeling better than when I first come in.

    It truly shows when you have health care professionals that enjoy what they do; I feel that their energy radiates onto their patients. Moreover, I get that from Dr. Christie and her staff who provide me with the quality compassionate care that I expect. 5 star treatment and I highly recommend visiting Dr. Christie for all your chiropractic needs!"
    - Paul G Seattle, WA
  • "I've been to many other chiropractors and not one of them took the time with me that Tiffany did. I was impressed with all of the treatments she offered besides adjustments. She did some soft tissue work on me and used a tool to help break up the scar tissue in my shoulders. I felt a ton of relief when I left. Dr. Tiffany is super sweet, which is a nice change from my last chiropractor who was all business. I LOVED the pre-treatment rolling bed she had me lie on. Get the muscles loosened up and just plain feels good! She also has some retail items that are helpful for aiding in sleeping ergonomically and physical therapy items. It was super nice to work with a chiropractor who wasnt in a rush to get me in and out. That made a big impression on me. Definitely give her a call!"
    Cary T. Seattle, WA
  • "Dr. Christie is amazing! Best upper cervical adjustments I have ever had. She also is quite skilled with Graston techniques. She is always ready to suggest a new kind of stretch, to help me between appointments. Not only is she a very knowledgeable, she is also a pleasure to interact with. Chiropractic care has never been this good!"
    Stephanie E

Featured Articles

Read about interesting topics

  • Chiropractic and Breech Babies During Pregnancy

    If you are experiencing back pain during your pregnancy or have a breech pregnancy, chiropractic can help. ...

    Read More
  • Natural Remedies for Sciatic Pain

    Do you experience sciatica pain? Both chiropractic care and at-home remedies can help alleviate that pain in a natural way. ...

    Read More
  • Chiropractic Care For Pets

    You know how chiropractic can help you, but what about your pets? ...

    Read More
  • Should I Use Heat or Ice for Pain?

    When you're feeling pain, sometimes it's difficult to determine if heat or ice will treat that pain best. This article will help you learn which is best for different types of injuries and pain. ...

    Read More
  • Should I Use Ice or Heat for Pain?

    Did you hurt your knee during an intense game of pick-up basketball this weekend? Or do you deal with chronic pain? Learn whether you should apply heat or ice for particular kinds of pain. ...

    Read More
  • Relationship with Self

    The relationship you have with yourself and the journey to self-understanding is an important part of your overall wellness. ...

    Read More
  • Indoor Activities and Exercises

    Are you preparing for the winter months or looking for exercises to do when you can't make it to the gym? Follow these exercises to maintain a healthy fitness routine. ...

    Read More
  • Holiday Stress - Take a Deep Breath

    Most of us pay little attention, if any, to the daily functioning of our many physiological systems. Our hearts beat, our digestive systems digest, and our various hormones, such as those deriving from the thyroid gland, adrenal gland, and pancreas, do what they do. It's all good... until it's not. ...

    Read More
  • Proper Overindulgence Over the Holidays

    Proper Overindulgence Over The Holidays The term "overindulgence" is probably best assessed as a red flag, especially with respect to consistent overconsumption of high-calorie comfort food and desserts during the holiday season. An overall healthier perspective could be described as "indulgence" regarding ...

    Read More
  • The 5 Senses

    The 5 Senses The five senses, that is, the sense of sight, touch, hearing, taste, and smell, provide us with necessary information regarding the world around us.1 These precious capabilities enable us to navigate our environment with seemingly instantaneous feedback with reference to our actions and ...

    Read More

NEWSLETTER SIGNUP

Sign up for more articles

No form settings found. Please configure it.