Many people wonder: should I use ice on this or heat this injury or ache.  I hope this helps you make an informed decision.


Ice is what I recommend the most to my patient.  Ice is a vaso-constrictor which means it causes the blood vessels to narrow and it limits internal bleeding at the injury site thus reducing swelling and pain.  Ice should be used on an acute condition which means a new condition of a sudden, sharp, traumatic injury.  An acute condition might be a fall or collision.  Ice is also helpful for chronic or long term injuries that might not have had a clear cause.  For chronic injuries it is best to ice after activity. For example, if you have long term knee pain, you can ice it after a run.

Ice should not be used directly on the skin or for longer than 20 minutes.  You can inexpensively buy ice packs that can shape to your problem or you can use a bag of frozen peas.  Ice several times per day, but make sure the skin reaches room temperature before icing again.  You may have heard to ice for twenty minutes on then twenty minutes off and repeat.  I usually tell my patients to ice every hour on the hour for twenty minutes so they can more easily keep track of time.  Ice an acute injury for three days.

Do not use ice if you are elderly with thinning skin or if you have hypersensitivity to cold, vascular disorders like Raynaud’s or Buerger’s, high blood pressure, or are experiencing frostbite.



Heat is generally used for chronic conditions or injuries that have no inflammation or swelling.  Heat is ideal for sore, achy, or stiff muscle or joint pain.  Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms.

Heat for no longer than 20 minutes at a time.  To avoid burning yourself, have a towel between you and the heat source.  Do not fall asleep on a heating pack.  When available, use moist heat.

Do not use heat if you have diabetes mellitus, active TB, encapsulated swellings, decreased thermal sensations, abdomen or low back pain during pregnancy, edema, or an acute condition especially if there is swelling.

Because conditions can be more serious than you assume, if conditions last more than 48 hours, see a doctor like Dr. Rachel for an examination.