When to use ice vs. heat?

This is a common topic discussed amongst most orthopedic clinics and holistic health centers. As a general rule of thumb, I like to tell my patients to ONLY use heat under one condition: you feel stiff. For all other reasons, choose ice. 

Ice is a wonderful anti-inflammatory. This means that when any pain or swelling occurs, ice will help bring down inflammation. Ice moves fluid out of the area of complaint, allowing the body to heal much quicker. According to Kathy Weber, MD., MS, and Director of Primary Care Sports Medicine Rush University Medical Center, Chicago, IL. ‘Ice diminishes pain, metabolism, and muscle spasm, thus minimizing the inflammatory response and improving recovery after soft tissue trauma. She also believes joints and muscles may benefit from routine use of cryotherapy even when an injury has not taken place’.  Icing for at least 15 minutes daily will decrease inflammation and allow the body to heal naturally. 

Heat is a pro-inflammatory. This means heat causes blood vessels to open leading to fluid rushing to the area where heat is applied. If there is soft tissue trauma, healing will be slowed. The heat will relax and calm stiff muscles by instantly triggering thermoreceptors in our body, which helps numb nociceptors (receptors in our body that detect pain). Heat, however, will not fix scar tissue or damage. Rather, it is a temporary bandage. Heating pads are among the most common sources of heat application. 15 minutes maximum will give the body the calming stimulation it needs.