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Heat or Ice? Which is Better for Your Pain?

Have you ever found yourself with an ache or pain wondering, “Should I apply heat or ice?” Here we’ll explain which situations call for heat and which call for ice, as well as what to do if neither is helping.

First off, a general rule of thumb is to use ice for recent, acute injuries that are less than 6 weeks old and heat, or a combination of ice and heat, for long-term injuries that have been persisting for over 6 weeks. The reason is ice constricts blood vessels, numbs pain and reduces inflammation, which is what you need for a new injury. Heat, on the other hand, increases blood flow and relaxes tight muscles. Heat can increase inflammation and cause congestion and compression in certain injuries, so give us a call if you are unsure which to use for your particular injury.

Heat is often best for:

  • Rheumatoid Arthritis.  (If you have Gout, this can respond either way.  Some people’s gout is made worse by either heat of ice… there is no predicting this one!)
  • Contracted muscles, by placing it over the large muscle “belly” (big, bulky part).  Ice would not generally be applied to the belly of a contracted muscle as it would tend to make it contract more
  • Relieving stiffness due to old strains and sprains after inflammation stage has resolved

Moist heat is usually best, like a heated grain-filled pad, a hot water bottle, or in a generalized application like a hot shower, bath, steam room.  Dry heat, as from an electric heating pad is not often as beneficial for muscles.

Ice is best for:

  • New injuries
  • Strains and sprains
  • Sports injuries and traumas
  • Throbbing headaches (often applied to the neck)
  • Tendinitis (commonly in the shoulder, elbow, knee, and wrist)
  • Generally applied across joints. (Heat would not usually be indicated across joints because it tends to increase the pressure within the joint.)

Applying Ice and Heat

In a pinch and don’t have one of those flexible, gel filled ice packs?  A bag of frozen peas or corn makes a decent substitute ice pack that molds to the injured area, but it will not stay cold enough throughout the needed 10-15 minutes. Conversely, a warm bath or shower, heat wrap, or heating pad can be used for heat therapy.

Apply heat or ice for 10-15 minutes at a time, taking a long enough break between sessions for the entire area to return to normal temperature. Remove the heat or ice if it becomes uncomfortable or numb, and do not apply ice directly to the skin, wrap it in a single layer of lightweight cloth like a tea towel.  For smaller, bony areas like fingers or feet, an ice bath is far more effective, as it penetrates better and surrounds the joints from all angles.  But ice baths are far more efficient as well, so you will only need a minute or two to get the same effect as 15 minutes of icing… don’t overdo it as you can freeze the area!  Repeating the ice bath 5 or 6 times with a few minutes between to rewarm is a particularly effective method of icing and “flushing” an inflamed extremity.

Did the Pain Improve?

Whether or not the pain improves with your home care, if it was more than just a “boo-boo”, give us a call.  We’ll get you in to make sure you’re on top of the problem not just resolving the short term pain.

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