Hot N Cold Therapies: When to Apply Heat and When to Apply Ice?

Application of ice and heat are two well-known and reliable means of achieving pain relief; however, despite often being associated together, they each possess distinct functions and times when their usage is particularly beneficial. If either is applied in the wrong scenario, an injury site and resulting pain experienced may be worsened. 

A good rule of thumb to follow and remember is that you should use ice for acute injuries with immediate inflammation and heat for muscular and chronic pain. After inflammation has been reduced via application of ice and an injury has begun to heal over time, you may switch to heat therapy to relieve any muscle stiffness and relax the injury site.

Heat Therapy: How Does it Work?

Heat helps to increase blood flow by warming muscles and loosening muscle fibers for a greater range of motion. There are two types of heat therapy: dry heat and moist heat. Each are very helpful for chronic conditions, such as arthritis and other stiffness of the knees, shoulders, fingers, elbows, and joints.  

• Moist heat is exactly what one might expect, with the most common examples being warm baths and hot damp towels. To relieve and relax tense joints via a warm bath, it is often recommended that the water be heated to 95 degrees.   
• Dry heat, as one might also expect, does not use water or anything dampened with water to achieve pain relief. Heating pads are the most common example. An easy way to make a DIY heating pad is to put a cup of rice in a clean sock, tie off the end, and heat it up in the microwave for 45 seconds.

When Should You Not Apply Heat?

Application of heat to the skin dilates nearby blood vessels. This can worsen inflammation in an area, which is why it should not be applied for acute injuries. The use of heat in these cases will delay proper healing as a result. 

Heat should not be applied to an open wound. Individuals with certain conditions such as diabetes, dermatitis, vascular diseases, deep vein thrombosis, and multiple sclerosis are generally encouraged to avoid heat therapy due to heig htened risks of burns and other complications.

Cold Therapy: How Does it Work?

The body typically reacts to injuries by triggering the onset of swelling, inflammation, and redness around muscle groups nearest the site of tissue damage. Cold therapy helps to constrict the blood vessels of the inflamed area, which helps to numb the pain, limit bruising, and reduce swelling back to its normal state. Cold therapy will additionally help to reduce any further damage at the injury site. 

Cold therapy can be achieved by placing frozen vegetable bags (frozen peas or corn), ice cubes in a bag, or frozen gel packs onto the skin surface. It is important to prevent ice burn by ensuring ice is not directly in contact with the skin. Additionally, the chilled item should not be kept in one place for the duration of treatment and should be lifted off the skin periodically. The benefits of cold therapy are particularly maximized if the cold item is flexible and able to wrap around the injury site. A bag of peas, for example, will cover a greater surface area of your skin than a solid rectangular ice pack. 

Cold therapy and icing an area can be particularly helpful at numbing pain and decreasing inflammation in cases of acutely onset pain and flare-ups of conditions such as gout. Ice baths are an effective practice for athletes who have sore muscles throughout their body. It is particularly to their benefit after sports that involve intense running and long durations of stress. 

When Should You Not Apply Ice?

Individuals who should not use cold therapy  are those with diabetes, stiff muscles or joints, poor circulation, or sensory issues. This may result in if applied in these cases. 

Individuals with stiff muscles or joints, poor circulation, sensory issues, and certain conditions such as diabetes are generally encouraged to avoid cold therapy. Application of cold therapy in such cases may increase the risk of  skin, tissue, or nerve damage.

A Few Precautionary Rules...

There are a few precautionary rules that should be followed when working with heat and cold therapies.   

1. Always apply a layer of protection between the hot or cold treatment and the skin. This is especially important if there are any open wounds that could be further injured.  
2. Avoid using extreme temperatures that may damage the skin or injury site–this applies to extreme heat and extreme cold!   
3. Do not apply heat or ice for more than 15 minutes at a time. Additionally, allow for 15 minutes of sufficient rest before reapplying. Having a cycle of “15 minutes on, 15 minutes off” is the best way to follow this rule. 

In Conclusion

Ultimately, heat therapy and cold therapy have opposite impacts on the body despite often being discussed together. When utilized correctly, they offer a quick, easily accessible, and affordable route to recovery and bodily repair for many individuals. Taking care of your injuries as soon as possible with easy methods such as heat and ice application may improve your lifestyle drastically! 

Written By: Aaliyah Sherfuddin

Edited By: Camden Rowe