Ice or heat for pain? Easy Ways to Choose Correctly Every Time!


Michelle Domonkos

“Wonder Twin Powers Activate!” Form of ice! Or wait, should it be heat? If you’re old enough to chuckle at this memory, you’re old enough to have some pain issues. Whether you’re in the throes of a nausea-inducing headache or are dealing with lower back pain that makes putting your shoes on a nightmare, we’ve all been there.

Maybe you’re the parent of an accident-prone child. Maybe it’s you that’s accident-prone. Either way, there may be days you’re limping along from a pulled muscle or days when the weather is bothering your arthritis. Knowing when to treat aches and pains with heat and when to use ice is an important life skill that you can master right now!

Listed below are some common ailments along with their corresponding treatment. The fundamentals are presented in different ways to help you grasp these concepts once and for all!

Heat increases blood flow to the application site. More blood flow means more oxygen and nutrients are traveling to damaged tissues. Great — this promotes faster healing! Imagine the warmth spreading through the tissues, soothing uncomfortable symptoms like chronic muscle aches and stiffness. Now you can see another benefit of heat is the sense of comfort and relaxation it offers. Chronic injuries and injuries over 6 weeks old do well with heat application.


Ice works in the opposite way. The cold slows blood flow to injuries by constricting blood vessels. Less blood flow results in less swelling and inflammation. Ice cools off hot, aggravated tissues caused by acute injuries and injuries less than six weeks old.

Warning! Incorrect use of extreme temperatures can result in tissue damage. The following guidelines help keep you and your loved ones safe:

• Use heat or ice for no longer than 20 minutes on and then remove it for at least 20 minutes. Any longer could result in frostbite or burns.

• Use a barrier such as a cloth for your ice or hot pack to safeguard against those dangers.

• Be careful if you have any decreased skin sensation from conditions like diabetes or Raynaud’s disease. You can damage your skin without noticing it.

1. Sprains and Strains

When an injury is fresh, it’s called an acute injury. For pulled muscles (sprains) and torn ligaments (strains) alike, start icing and elevating the injured area right away. Swelling and pain start shrinking as the blood vessels begin shrinking. We all know about cold and shrinkage, right? Once the inflammation dies down, you may be lucky and feel better. But you could have more healing to do. And this chronic injury stage may last a long time. Stiffness is a big problem at this stage. Heat’s soothing effects helps loosen any remaining tightness. The double o’s in these words may spark your memory to choose heat for these injuries.

2.Tendon Injuries

Tendons that attach to joints may become inflamed with overuse or injury. Tendons are tough guys. Throw some ice on them to cool them down when they are acting up in the acute phase known as tendinitis. Tendons are notorious for taking longer to heal than muscle. Because of this, chronic conditions are very prevalent. Tendinosis is the term used for the stage of chronic irritation and stiffness. So once those bad boys have calmed down, loosen them up with some soothing heat.

Are you starting to see how it works?

3. Headaches

With the rise of text neck, eye strain, and stress building in our lives, it’s no wonder headaches are so common. Whether you choose ice or heat does matter depending on the type of headache you’re experiencing.

Tension headaches are caused by the tightening of blood vessels in your head, face, and neck. Dull aching, tightness, and tenderness all describe this type of pain. Since this kind of headache often feels like your head is screwed on too tight, you need to heat it up. Just like you’d run a tight jar lid under hot water to loosen it up, you need a hot pack on your head pain. At first, it might seem counterintuitive to put heat on a headache. But remember, you need to increase blood flow to open up tight blood vessels.

People with throbbing headaches experience pain that pulses with their heartbeat. So what can you do to stop these waves of pain? Freeze them in their tracks! Just like cold can freeze waves in place, stopping their movement, an ice pack can constrict blood flow to inflamed areas, dulling the nerves affected. Migraines are a more severe variety of throbbing headache. Not only do you get pulsing pain, but you may also get nausea, vomiting, and sensitivity to light and noise. Most migraine sufferers need an ice pack to slow down blood flow and ease the pounding.

Arthritis is a lesser-known cause of headaches. These are literally a pain in the neck. Since the head and neck muscles connect, the pain can spread throughout the whole area. Most people are familiar with the concept of how cold worsens arthritis. Even sitting in a cold draft could bring on a headache for a sensitive sufferer. If this is you, imagine how nice it would feel to have warmth coursing through your bloodstream. What you’ve learned should have you reaching for a heating pad to ease your aching. Acute inflammation can also trigger an arthritic headache. In that case, ice is the best option.

What about killer hangover headaches? Along with plenty of fluids, a hot compress can also help you feel better after drinking too much alcohol. Again, it might not seem natural to choose heat when you’re feeling this awful. According to Jerrold B. Leikin M.D., director of Medical Toxicology at NorthShore University HealthSystem, too much booze makes your brain’s blood vessels enlarge at first. As the alcohol’s effects begin to wear off, those vessels constrict. So your poor brain’s blood vessels are as shriveled up and thirsty as you feel right now. Dilating the vessels back to their normal size with heat and rehydrating your body should bring relief.

4. Arthritis

Even though it’s thought of as an older person’s problem, arthritis can strike at any age. Inflammation and stiffness, along with swelling and tenderness in the joints, are the signs of this disease. The symptoms may become severe enough to limit the activity of those suffering from it. Millions of people rely on heat and ice therapy to keep stiffness at bay. Which one you choose depends on the type of arthritis you have. Here’s a quick breakdown of some of the most common ones:

Osteoarthritis develops when the cartilage protecting the tips of your bones in your joints has worn away. The most common kind of arthritis, it’s a progressive condition, meaning it worsens over time. Exercise, weight loss, therapy, and medication can all help relieve your symptoms.

Rheumatoid arthritis is different because it’s an autoimmune disease. In this condition, the immune system is confused and attacks healthy cells in the joints. The result is painful swelling. RA, as its more commonly known, is also a progressive condition. Physical therapy, stretching, and medications are options available to manage this disease.

Gout arises when too much uric acid in the blood forms sharp crystals that collect in the joints. These tiny, spiky crystals cause a sudden onset of severe pain. Gout attacks can be minimized by managing risk factors including, diet, obesity and, avoiding certain medications.

Moist heat helps loosen up stiff joints caused by the first two types of arthritis above. The way it works is a lot like thawing out something from your freezer. If you threw a big steak in there and it got bent, there is no way you can straighten it out until it thaws. The same happens with arthritic joints. They need low, slow heat to regain flexibility. Warm baths or paraffin wax dips are great options. If you can, start devoting time to regular heat therapy. Doing so can lead to less pain and more mobility. Adding a stretching routine after heat therapy would be even better for you!

Gout is the outlier in this arthritic trio. Because it can have a very sudden onset and it’s so painful it’s even been described as feeling like having broken a bone right out of the blue! Gout is another “bad guy” that needs to chill out.

5. Lower back pain

For acute lower back pain, the concept of using cold therapy for a fresh injury applies again. Imagine you fell on slippery ice and tweaked something in your back. You might not be able to get up right away, and that’s ok because the ice you need is right there. Lower back inflammation may be reduced by using ice for 20 minutes at a time as outlined above. Once the shock of your injury has worn off, and your pain settles down, switch from ice to soothing heat.

Chronic back pain is a chameleon. “We have seen that back pain responds to heat and ice differently from patient to patient, and the response is greatly influenced by things like how chronic or frequent a patient has to deal with the problem,” says Dr. Rami Said of The Spine Center at Columbia University. Find what works for you. A hot shower in the morning may be just what you need to loosen your stiff spine. Ice may be necessary later in the day if activity aggravates your back.

Next time you find yourself needing relief, remembering these basic principles should get you on the fast track to feeling better. There’s nothing wrong with experimenting to find what works best for you. Still in doubt? Remember this advice: If it’s an emergency, grab the ice! If the pain has been simmering, grab your heating pad.

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