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May 2010
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Ice vs. Heat – Which is Best?

One of the most common questions I hear on a weekly basis is, “Should I use heat or ice when it hurts?”  This is a very common dilemma that most people face when they are in pain.  The use of heat and ice can provide great benefit but only when used in the right situations.  So, here’s a general guideline to help you answer that question the next time you feel pain.

Heat is often a better choice when dealing with symptoms that involve stiffness and tightness.   The reason heat works well in this situation is because its effects on circulation.  The use of heat will INCREASE circulation to an area.  More blood flow = more oxygen and nutrients delivered to the area in question & more waste products removed from the area in question.  Think about the last time you took a long hot shower or relaxed in a sauna.  Within minutes, you tend to feel looser and more relaxed which is always the right choice when dealing with stiffness, tightness and an overall decrease in range of motion.

Ice, on the other hand, is a better choice when dealing with symptoms that involve swelling, inflammation or acute pain.  The reason ice works well in this situation is also because of its effects on circulation.  However, the effect on circulation is the EXACT OPPOSITE to that of heat.  Ice causes a DECREASE in circulation which is important during the onset of injury because it helps to regulate inflammation.  Inflammation is the body’s normal response to injury but often times it can result in moderate swelling and pain.  I always remind my patients that ice puts out the fire.  Ice is a great choice during the first 48 hours and will help decrease pain and swelling while the body undergoes the healing process.

Regardless of the choice between heat or ice you want to make sure you never apply them for more than 20 minutes.  More often than not, people will use heat or ice under the right circumstances but the mistake that is made is keeping it on the body for hours instead of minutes.  Prolonged exposure to heat or ice for more than 20 minutes can have the reverse effects.  This can lead to an increase in pain or stiffness or inflammation depending on the situation.

So remember, use heat when you are experiencing tightness and stiffness and when an injury is chronic BUT use ice during the first 48 hours of an injury to help put out the flames of inflammation.  If you’re not sure of whether you should use heat or ice the next time you are in pain, then contact your local healthcare professional at AITC to make the right choice.