How to Know if you Should use Heat, Ice or Both

June 5, 2020

Maybe you went a little overboard at your aerobics class and are feeling it in your knees. Or the arthritis in your hands is causing lots of achiness and stiffness today. Should you use ice, heat, or a combination of both? Here is some basic information to help you make the right decision for your pain relief.

As a general rule of thumb, ice is used for acute injuries or pain along with inflammation and swelling. It is best to use heat therapy for muscle pain or stiffness. Heat therapy works by increasing circulation and blood flow to a particular area which causes an increased temperature which can help relax and soothe muscles and injured areas.  

There are two different types of heat therapy, dry heat, and moist heat. Dry heat includes heating pads, dry heat packs, and even saunas. Moist heat includes steamed towels, moist heat packs, and hot baths. Moist heat may be slightly more effective and can require less application time with the same result.

Heat therapy is often helpful when used for a good amount of time, in some cases, 15-20 minutes is sufficient to help ease stiffness or tension. More severe pain can benefit from longer periods of heat therapy, such as a warm bath lasting anywhere from 30 minutes to 2 hours.  Risks of heat therapy include burning your skin if the heat becomes too hot or an increased risk of an existing infection spreading.

There are certain cases where applying heat is not the best option and cold therapy should be used. With bruising and/or swelling or in the case of an open wound, it may be better to use cold therapy. Additionally, people with certain medical conditions should not use heat therapy due to a higher risk of burns or complications. Types of conditions include diabetes, dermatitis, vascular diseases, deep vein thrombosis, and MS. If you have hypertension or heart disease you should ask your doctor before using heat therapy.

Cold therapy, which is also known as cryotherapy, reduces blood flow to a particular area. This reduces inflammation and swelling which can help ease pain. Cold therapy is especially effective around a painful or stiff joint or tendon. This type of therapy also reduces nerve activity which further aids in the relief of pain. Types of cold therapy treatment can include ice packs, coolant sprays, ice massage, or ice baths.

People with sensory problems that prevent them from feeling certain sensations, especially diabetes, should not use cold therapy as this can result in nerve damage and lessened sensitivity. Cold therapy should not be used if you have stiff muscles or joints or if you have poor circulation. When icing an injury, you should never apply ice or a frozen item directly to the skin as it could damage the skin and tissue. 

Cold therapy should be applied as soon as possible after an injury and should only be used for short periods of time for around 10-15 minutes, but no longer than 20 minutes. Risks of cold therapy include skin, tissue, or nerve damage if the cold is applied for too long or too directly.

Some injuries and types of pain can benefit from the combined use of both heat and cold therapy. Cold therapy can help with the initial inflammation and swelling of an acute injury and help numb the pain. Once the swelling has gone down, heat can increase blood flow to help ease the stiffness and soreness in the area. This is often the case with swelling and pain caused by arthritis. It is often recommended to use a 20 minutes on, 20 minutes off process with both heat and cold therapy.

In summary, ice is the answer for acute pain, inflammation, and swelling. Heat is the way to go for arthritis and injuries that last for more than six weeks. If these therapies are not providing relief after consistent treatment, you should contact your physician for an evaluation to ensure there is not a more serious condition involved. For chronic inflammation, painful joints, muscle pain, and all your orthopedic care needs, The Orthopedic Specialists providers are here to help. Call us today at  (515) 955-6767 for all of your bone and joint issues, with no referral necessary!

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