When dealing with painful areas or injuries, one of the most common questions PTs are asked is, “Is it better to use heat or ice?” The simple answer is YES! Both heat and ice have different benefits and one might be more indicated based on the type of injury. Let’s discuss further:

It’s Getting Hot in Here

Heat is typically used more for muscle pain or stiffness. Heat improves circulation, which in turn promotes tissue healing. Pain, discomfort, and flexibility can also be affected positively by the use of heat. Applying heat to an area is typically done in one of two ways. Dry heat also called conduction heat, includes such methods as heating pads, dry heating packs, and even saunas. In most cases, they are easy to apply. Moist heat, sometimes referred to as convection heat, would include such methods as steamed towels, moist heating packs, and hot baths. Moist heat may also be more effective than dry heat and typically requires less application time. One study even found moist heat to require only 25% of the application time of dry heat.

There are cases in which heat would not be appropriate. Areas that are bruised or swollen, or have an open wound should not have heat applied. In addition, certain conditions that would predispose someone to an increased risk of burns or complications should also avoid heat. These would include, diabetes, vascular disease, multiple sclerosis, deep vein thrombosis, and dermatitis.

Ice Ice Baby

In opposition to heat, ice is effective in treating areas that are swollen. Ice is also typically used more for acute injuries. Ice works in the opposite way of heat, by reducing blood flow to an area, thereby reducing the inflammation present. Ice can be applied using methods like ice packs, frozen gel packs, coolant spray, ice massages, or ice baths.

However, people with sensory disorders should avoid cold, as they may not be able to feel if the damage is being done. Additionally, the time duration in which cold is applied should not exceed 20 minutes and cold should never be applied directly to the skin, due to the risk of damage to the tissue.

Ice and Heat can be effective tools in treating pain, stiffness, or acute injuries (check out this article for more information). Understanding when to choose one over the other will help maximize healing while limiting adverse side effects.

JUST REMEMBER: Heat is Neat, and Ice is Nice.

-Written by Colin Fulton, PTA




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