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Should I ice or heat?

Most people know that if they sprain their ankle, they should ice it. But what do you do if your back is hurting or if you wake up with neck pain? Or what do you do for that ankle a week down the road when it is still achy but not necessarily swollen? When you learn more about the action of both ice and heat, it should help you decide which one would be best for you. Ice helps with inflammation. What is inflammation? When tissue gets injured, a few events happen. Blood vessels dilate to bring more blood to the injured area, capillaries (small blood vessels) become more permeable and allow bigger and more molecules to seep out of the vessels, and an immune response brings infection-fighting cells to the area. The increased amount of fluid causes redness, warmth, and pain from the pressure and chemical irritants. Ice helps to decrease the circumference of the blood vessels, therefore minimizing the amount of swelling.

It is important to remember that inflammation is a natural response and should not be suppressed completely. It is the body’s way of helping to heal the injured area. It is important to remember, though, that more ice isn’t better. As with heat, ice should not be left on for more than 15-20 minutes at a time.

Heat works the opposite of ice. It helps to bring fluid to the area and increase circulation. That is why heat is used on joint stiffness or chronically tight muscles. You can even use a combination of ice, then heat, then ice, then heat to create a pumping action to increase circulation. This is done after the acute phase of an injury.

So when do you ice and when do you heat? Below is a basic chart on when it is appropriate to ice, and when heat would be a better option. Just a reminder…you can often do more harm if you heat at the wrong time but rarely does choosing to ice cause problems.


Ice or Heat?
Ice Heat
When To Use Use ice after an acute injury, after activities that irritate a chronic injury, or whenever it feels better than using heat. Ex: sprains, shin splints, headache Use heat before activities that irritate chronic injuries, or to help ease stiffness. Heat can help loosen tissues and relax tight areas. Ex: arthritis, tense muscles.
How To Do It Ice pack, ice in a bag, ice cup, frozen veggies in a bag, ice bath (with caution) Heating pads, hot tubs, saunas, a hot shower. Stretching muscles while heating can help loosen the tissue as well.
For How Long Apply ice treatments for no longer than 20 minutes at a time. Too much ice can do harm, even cause frostbite. Wait at least 20 minutes after icing to reapply. It is not necessary to apply a heat treatment for more than about 20 minutes at a time. Never apply heat while sleeping.

Taken from with some changes to content and format.