Should You Ice or Heat an injury? The simple answer is, treating pain with hot and cold can be extremely effective for a number of different conditions and injuries, and easily affordable. We can treat everything from arthritis to pulled muscles to inflammation with ice packs or heating pads. Basically, ice packs and heating pads are among the most commonly used treatments in orthopaedics. The tricky part is knowing what situations calls for hot, and which calls for cold. Sometimes a single treatment will even include both.
So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last? As a general rule of thumb, use ice for acute injuries or pain, along with inflammation and swelling. Use heat for muscle pain or stiffness.
Read on for information about treatment of injuries with ice packs and heating pads.
Ice Treatment
Cold therapy is also known as cryotherapy. It works by reducing blood flow to a particular area, which can significantly reduce inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain. Ice treatment is most commonly used for acute injuries. If you have had a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice. Ice packs can help minimise swelling around the injury, reduce bleeding into the tissues, and reduce muscle spasm and pain.
Ice packs are often used after injuries like ankle sprains have occurred. Applying an ice pack early and often for the first 48 hours will help minimise swelling, and decreasing swelling around an injury will help to control the pain. Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity.
You can make ice packs with ice cubes in a plastic bag or wet tea towel; a pack of frozen peas is also ideal and can go in and out of the freezer. Never place ice directly on an injury; keep the pack moving to avoid ice burns. Never treat with ice for more than 30 minutes, and remove the pack immediately if the injury appears bright pink or red.
Don’t use ice packs on the left shoulder if you have a heart condition, and don’t use ice packs around the front or side of the neck.
Heat Treatment
Heat therapy works by improving circulation and blood flow to a particular area due to increased temperature. Increasing the temperature of the afflicted area even slightly can soothe discomfort and increase muscle flexibility. Heat therapy can relax and soothe muscles and heal damaged tissue. Heat treatments should be used for chronic conditions to help relax and loosen tissues and to stimulate blood flow to the area. Use heat treatments for conditions such as overuse injuries before participating in activities.
Do not use heat treatments after activity, and do not use heat after an acute injury. Never use heat where swelling is involved because swelling is caused by bleeding in the tissue, and heat just draws more blood to the area.
Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping.
Other Precautions
Don’t use cold or heat packs:
- over areas of skin that are in poor condition
• over areas of skin with poor sensation to heat or cold
• over areas of the body with known poor circulation
• if you have diabetes
• in the presence of infection
Resources:

Meet Dr Peter Smith, a leading Orthopaedic Surgeon operating from the Mediclinic Milnerton in Cape Town, Western Cape. His practice is situated in the heart of this seaside town. Dr Peter Smith not only offers patients the full spectrum of professional orthopaedic treatments, but specialises in total knee replacement, total hip replacement, sports injuries and the latest arthroscopic surgery techniques and computer guided surgery. He gained extensive experience in the latest arthroplasty techniques during his stay of 6 years in Australia where he performed more than a hundred primary and revision hip and knee replacements cases in a year.
Call today!
Contact us for more information by clicking on the button to call us directly.