When to use a heat or ice pack
Several times a week I get asked by a patient, ‘What should I use for pain relief, heat or ice?’ A straight forward answer is often hard to give, sometimes its one or the other or sometimes a combination of both. Confused? Lets try to clear this up.
To Ice or Not To Ice
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I always recommend ice for an acute injury or trauma. For example, when you have just rolled your ankle playing football with the kids or pulled a hamstring muscle trying to compete with a person beside you in yoga class.
If there is a lot of swelling, redness and heat present around the injury, then it is best to follow the R.I.C.E.D protocol for pain and inflammation management. R = rest, I = ice, C = compression, E = elevation, and D = diagnosis by a qualified health professional.
Other occasions were ice can give fantastic relief from intense pain is when the pain is highly irritable or the injured area is extremely sensitive, that is it doesn’t take much to provoke the pain and once the pain is present it stays for quite some time.
There are a couple of important things to note when using ice. First, there is a time limit! You should only ever put ice on for a maximum of 15min before taking it off. You can reapply once the area has returned to a normal body temperature. Also, be careful if there is already numbness in the area or if there is an irritable skin condition – it’s not a good idea to put ice on in these conditions.
Heat Glorious Heat
I’ve found heat is great for chronic conditions like arthritis. It also works really well for pain caused by postural strain – the kind of pain you can get from sitting at a computer screen for 8 hrs a day.
Heat helps promote the circulation of blood and lymph through the body. It’s great at moving new blood full of important nutrients and oxygen into the tissues to aid in the healing process. It also helps with the drainage of old blood away from the injury by opening up the veins and lymph vessels to help with the removal of cellular waste.
In most cases I recommend trying heat first for most conditions that aren’t the due to an immediate trauma.
Heat is great at helping to relax tight muscles that have tightened to protect a injured area, as is the case in a lot of low back pain sufferers who often develop very tight leg and buttock muscles.
Heat can be applied in various ways; from a hot shower or bath, to a wheatbag, hot water bottle or gel pack. There is no time limit for heat, just don’t burn yourself. (It has happened!)
So as a general rule:
- Ice for acute inflammation or nerve pain.
- Heat for muscle tightness, and pain resulting from bad posture and chronic conditions.
- When in doubt, try heat first and if that does nothing or makes if feel worse then try ice.
