Heat and ice are both considered an inexpensive, easy-to-use treatment option for injuries and pain. But in the moments or even days after an injury, people often forget which choice provides the most benefit.

Michael Behr, M.D., an orthopaedic surgeon at Piedmont, says there is really no right or wrong answer, but he says ice is typically used for acute or recent injuries, while heat is used for muscular and chronic pain.

“Ice is a great choice for the first 72 hours after an injury because it helps reduce swelling, which causes pain. Heat, on the other hand, helps soothe stiff joints and relax muscles. However, neither option should be used for more than 10 to 15 minutes at a time.”

When to use ice

Ice helps minimize swelling. By applying an ice pack, bag of frozen vegetables or cold washcloth at the onset of an injury, swelling can be controlled, which minimizes pain. Dr. Behr says it is okay to have direct exposure to ice only if it is short-term. Otherwise, applying a layer between the ice and your skin is highly recommended.

When to use heat

“Heat actually has the opposite effect of ice,” Dr. Behr says. “It causes small blood vessels to open which can stimulate inflammation rather than relieve it.”

Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Heat is a great treatment option for chronic conditions caused from old injuries or even arthritis. Heat can be applied before participating in activities to help limber up. Dr. Behr advises against using heat treatments after activity or after an acute injury because heat can cause the swelling to worsen.

Heating pads are the most common heat source, but even a hot, wet towel can bring relief.

Ice and heat in moderation

In his 21 years of experience, Dr. Behr has seen patients who have suffered from burns due to excessive use of either heat or cold. It is important to remove the heating pad or ice for 15 to 20 minutes after each treatment period.

“Some people do not tolerate ice or heat well. It often comes down to a personal preference of what brings relief to your symptoms. It’s also important to remember that heat and ice are not a cure for any injury, but are a source of comfort,” Dr. Behr says.

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