We get asked this a lot in clinic. Which should I use? Heat or Ice?
There is a lot of evidence out there about whether Ice and Heat are effective for pain relief. A lot of it is contradictory and it’s changing frequently. However, from experience, we know that a lot of people find both Ice and Heat to be effective at reducing pain.
So which is best? Heat or Ice?
This will vary depending on who you ask. Osteopaths and Chiropractors for example will nearly always recommend you use ice for most things. Physios tend to recommend heat for more things, but it does vary.
Neck and Back pain
Generally speaking, if you have pain somewhere near the spine, usually neck or back pain, we’d recommend you use heat. This can be in the form of a hot water bottle, a wheat bag that you put in the microwave, heat patches, a hot bath or shower. Anything really as long as it’s warm (but not too hot).
We generally recommend this for back and neck problems, because a lot of the pain you feel is from muscle spasm. If you put heat on tight muscles they will generally relax. This will usually help to reduce pain. Heat will also usually reduce the arousal of the nervous system. With a less sensitive nervous system, you will also generally have a little less pain.
Generally you’d use heat throughout the course of the problem.
Sports injuries and swelling and bruising
Generally if you’ve hurt yourself doing something, such as twisting your ankle, we’d recommend you put ice on the injury. If there is bruising and / or swelling, the idea is that the ice reduces the blood supply in that initial stage of the injury which reduces the amount of swelling that goes to the area. Some swelling is ok, as it contains the building blocks of repair, but excessive swelling causes pain and gets in the way. Ice can keep the swelling down.
Generally you’d use ice for the first 72 hours or so, to limit swelling, and then switch to heat to encourage blood supply, clearance of the swelling and faster healing.
How long and how often?
We recommend you use ice or heat for about 15-20 minutes, upto 3 or 4 times per day. In reality, people often use it more frequently, particularly if it gives people relief from the pain, and that’s fine.
Not too hot or cold!
We sometimes see people who have used Ice or heat at home for pain relief and have caused themselves a burn in the process. Although tempting to make it really cold or really hot, in reality, adding a burn to the area is never going to help things so be careful. Always make sure there is something between your skin and the hot or cold object. Make sure you check the area regularly and stop using the heat or ice if the skin is in any way damaged.
This is just very rough guidance
We’d always recommend you see someone to find out the best way to reduce your pain and get you back to doing the things you enjoy as quickly and as safely as possible. However, the rough guidance above should give you a good idea of where to start in the mean time before seeing someone, and will hopefully calm the pain a little quicker. It will also hopefully help you feel a bit more in control of the pain, which is important too.
If you have a problem and want to know what you can do to regain control and get back to your normal day to day activities, then please get in touch with your nearest clinic here.