We always get asked at Wandsworth Town Osteopathy: should I use ice or heat to reduce my pain and aid my recovery?
The general rule is to use ice for the initial days immediately following an injury. This is called the acute phase. Ice is useful in reducing swelling and inflammation in the acute phase which helps to reduce pain and swelling in the localised area, and prevent further damage to neighbouring tissues.
Heat is more suitable for chronic long term problems aiming to reduce tension and spasming in muscles by increasing the blood flow. The heat also aids strain and sprain injuries that aren’t healing well. Heat is especially helpful for reducing stiffness in tight muscles.
Some chronic injuries do fair better with ice due to inflammatory flare ups such as arthritis or tennis elbow. But it varies with each case so it is advisable to try both and see which is best for you.
One of the main things to note however is that heat can aggravate pain, so always try ice first if you are unsure. Heat increases inflammation and even though inflammation helps the body to heal it also acts as an irritant and can antagonise pinched nerves and damaged tissues. Don’t use heat if the area is hot, red or swollen. With regards to timings always wrap ice and your heat source (such as a hot water bottle) in a towel and only apply for up to 10 minutes at a time to prevent burning.
If you have a recent pulled muscle, muscle strain, muscle tear or ligament strain then ice is the one to use for the first week or so. Heat is then recommended in the medium to long term management, especially before exercising these body parts.
The way that heat works is by stimulating blood flow which floods the damaged area with oxygen, water and nutrients all of which are needed for tissue healing and recovery. It also relaxes the muscle through this increase in blood flow, and prevents the build up of lactic acid which also causes muscle pain.
The way that ice works is by reducing swelling and inflammation. Inflammation and swelling is the body’s natural response to protect and begin healing damaged tissues. The body however often over exaggerates the amount of swelling needed and this can damage structures around the symptomatic area. Inflammation is also an irritant and as discussed above can aggravate nerves. Ice narrows the blood vessels therefore reducing the opportunity for swelling and inflammation.