Heat or Ice?

A frequently asked question is

“Should I use heat or ice?”

I tend to give the answer that if the problem is acute or sharp in nature Ice is usually the answer but if the problem is more chronic in nature, dull and achy the answer is usually heat. However I thought it might be useful to explore the benefits of heat and Ice.


The application of heat to an area:

  • Increases blood flow - this has brings with it oxygen and proteins to the area.   This aids the healing of the injury.

  • Stimulates the sensory receptors in the skin - this can decrease the transmission of pain signals to the brain which can help to alleviate pain.

  • Promotes tissue flexibility - this allows more freedom of movement and can aid the restoration of mobility.


The application of ice to an area:

  • Decreases blood flow to the area - this can prevent swelling and further injury. However inflammation is part of the healing process so there is debate on whether ice application may slow down the healing process.  I believe the use of ice in the first 48 hours has benefits in preventing secondary tissue damage due to excessive swelling. However, after the 48 hours ice can be used more sparingly to allow a level of inflammation to occur to allow the natural healing process to progress but still control pain.

  • Stimulates the sensory receptors in the skin - as with heat application ice can slow down the transmission of pain signals to the brain and can help alleviate pain.

Ice must not be used for longer than 20 mins per application - prolonged ice use has the opposite intended effect and causing the body to go into protection mode and push blood to the area to prevent cold damage.


Heat and Ice are cheap and easy to access - I do not believe there is any great added benefit to using expensive heat or ice pads when a hot water bottle and bag of peas can do the job.  Care must be taken to avoid the risk of a heat or ice burn, this is especially important to consider if the skin sensation of the patient is compromised.

Ice should not be applied directly to the skin but though a damp tea towel and heat through a cotton towel.