Is heat or ice better for pain?
“Ice is a great choice for the first 72 hours after an injury because it helps reduce swelling, which causes pain. Heat, on the other hand, helps soothe stiff joints and relax muscles. However, neither option should be used for more than 10 to 15 minutes at a time.”
Heat helps soothe sore muscles that cause back pain or neck pain. It works best for injuries that are at least few days old. Heat opens blood vessels, which can assist the healing process and alleviate some of your pain. Additionally, some arthritis pain from stiff joints can benefit from heat as blood flow increases.
Ice helps reduce inflammation and numb pain, whereas heat helps relax muscles and stiff joints. While heat helps improve circulation and blood flow, ice reduces blood flow thereby reducing inflammation and swelling.
Treatment for a Sprained Ankle
So, typically, ice decreases blood flow to an area, which causes less swelling, whereas heat will bring blood flow to an area which can cause more swelling. Usually, in the first two to three days after an injury, we would recommend ice only.
Icing is effective at reducing pain and swelling because the cold constricts blood vessels and decreases circulation to the area. For example, if an athlete rolls an ankle in a volleyball match an immediate application of ice will cut down on long-term swelling and potentially lessen recovery time.
Researchers know that pain tends to flare up during hot, humid summer days, but all the reasons for this are unknown. Many chronic pain conditions seem to be affected, including osteo and rheumatoid arthritis, fibromyalgia, Multiple Sclerosis, migraine and tension headaches, and aches from old injuries.
That's not to say putting heat on an injury is out of the question — however, never apply heat to a new injury that is still swelling. Heat will make the swelling and pain worse, which is not what you want. You also should not apply heat if your body is already hot — for example, if you're sweating.
Fast facts on cold and heat treatment:
Cold treatment reduces inflammation by decreasing blood flow. Apply within 48 hours after an injury. Heat treatment promotes blood flow and helps muscles relax. Use for chronic pain.
Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.
Weather and chronic pain
Inflammation — Heat and humidity can affect the level of synovial fluid, which is the fluid that lubricates the joints. This can lead to inflammation within the joints. Heat and humidity can also increase overall levels of inflammation in the body, which can increase pain.
Should you ice or heat first?
Rule of thumb for most injuries: Ice first, heat later. But avoid using them in tandem except as directed by a health care provider, Jake said. Most injuries cause your body to react with inflammation and swelling. Ice is used to cool down the injured joint or tissue and reduce swelling.
Generally, heat should be applied 1-3 times a day for 10-15 minutes at a time – however, if heat is added too early in the healing process, it can perpetuate the inflammation cycle and be harmful to the body. Ultimately, the decision to use heat or ice is up to you.

Heat boosts the flow of blood and nutrients to an area of the body. It often works best for morning stiffness or to warm up muscles before activity. Cold slows blood flow, reducing swelling and pain. It's often best for short-term pain, like that from a sprain or a strain.
Yet, leaving a heating pad on for too long can result in injury from burns and can potentially create a scenario of extreme inflammation in the body as the dilated blood vessels bring pro-inflammatory cells to the area warmed.
Cryotherapy (ICE):
The research shows icing disrupts inflammation, delays neutrophil and macrophage infiltration as well as the anabolic hormone Insulin-like growth factor (IGF-1) that sparks the next phase of the healing process, muscle repair and regeneration.
Heat and Chronic Pain Conditions
Any rise in temperature means worsened symptoms, which means a hot summer day can make pain exponentially worse. This problem is so common, it has a name: Uhthoff's Syndrome. Once the heat backs down, symptoms tend to disappear.
Heat and Joint Pain
While cold weather can increase aching, warm weather typically increases swelling and pain. This means that the increased pressure and humidity outdoors can increase the expansion of joints, tendons, muscles, and even scar tissue, leaving many of us with previous injuries in pain.
Here's why. Your peripheral nerves that signal to your brain whether it's cold or hot can also send pain signals. When your nerves are damaged, your brain may translate the change in cooler temperature to feelings of tingling, sharp or burning pain.
The truth is, treating low back pain with ice can make the pain worse. Icing these areas can actually cause the body to feel threatened. In many cases, you will immediately notice that the muscle spasm increases the second you place ice on the injured area.
Nerve Pain
It's best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.
Should I use ice or heat for arthritis pain?
For an acute injury, such as a pulled muscle or injured tendon, the usual recommendation is to start by applying ice to reduce inflammation and dull pain. Once inflammation has gone down, heat can be used to ease stiffness. For a chronic pain condition, such as osteoarthritis, heat seems to work best.
“Heat actually has the opposite effect of ice,” Dr. Behr says. “It causes small blood vessels to open which can stimulate inflammation rather than relieve it.” Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.
Studies on turmeric, rosemary, cinnamon, cumin, and ginger show they may slow down processes in your body that lead to inflammation.
PHILADELPHIA (CBS) -- Heat can increase pain for people with a variety of conditions, like arthritis, in addition to making you feel miserable and increasing the risk for dehydration. Heat and humidity trigger inflammation that can make achy joints feel even worse.
After an acute injury, ice should be used to minimize swelling for the first two to three days. After this period, heat can be used to increase blood flow and assist the natural healing process. Applying heat too early may cause additional swelling by increasing blood flow to the injury.
Ice & Heat Together
To achieve therapeutic results, you must do this in a very specific way. The key is to ice for 20 minutes, causing the vessels to narrow, and then heat for 15 minutes, causing the vessels to dilate. This acts as a pumping mechanism to the inflammation, pushing it away from the injured area.
Heat Therapy for Chronic Pain and Stiffness
While cold decreases circulation, heat therapy works by increasing blood flow and relaxing muscles, making it a good choice for muscle spasms and stiffness. Because heat can make inflammation worse after an injury, use it for chronic pain issues.
The inflammation of joints or pain caused by worn-away cartilage in joints can cause pain and stiffness in places like your elbows, knees, shoulders and fingers, just to name a few. For these instances, moist heat, like a soak in a tub or shower of warm-but-not-hot water (92-100°) helps.
These are the most common: Pathogens (germs) like bacteria, viruses or fungi. External injuries like scrapes or damage through foreign objects (for example a thorn in your finger) Effects of chemicals or radiation.
Heat and cold therapy may help ease arthritis symptoms. Heat therapy increases blood flow and may help to soothe stiff joints. In contrast, cold therapy constricts blood vessels and may be useful in reducing stiffness and inflammation. People can alternate between heat and cold as necessary.
How should I rotate ice and heat?
If you use both ice and heat, apply heat for 15 to 20 minutes, then a few hours later use ice for 15 to 20 minutes. Do this at spaced intervals throughout the day. By rotating between each temperature therapy, you're reducing inflammation and loosening muscles simultaneously, increasing your chances of pain relief.
When an injury or inflammation (such as tendonitis or bursitis) occurs, tissues are damaged. Cold numbs the affected area, which can reduce pain and tenderness. Cold can also reduce swelling and inflammation.
Applying heat to a body part stimulates blood circulation to the injury site. This oxygen-rich blood brings nutrients to the affected area, promoting healing. Heat also helps to remove lactic acid buildup from overtaxed muscles, which allows them to “un-clench.”
Heat application reduces pain by bringing more blood flow to the area by vasodilation. This increases circulation and muscle relaxation, which reduces pain, spasms, and stiffness, says Dr. Gardner. Heat also prevents the buildup of lactic acid in muscles, which can cause pain.
“Naproxen [Aleve] and ibuprofen are better for inflammation and muscle strains. A bonus of Naproxen is you can take it twice a day versus every 4 to 6 hours like with acetaminophen. This can be more convenient for many people.”
Heat applied directly to a local area, like with heating packs, should not be used for more than 20 minutes at a time. If you experience increased swelling, stop the treatment immediately.
Conclusion: Gel packs were more effective at cooling than ice and water combinations.
- Skin rash or burn. Prolonged use of hot packs and heating pads, or application of a heat source that is overly hot without a barrier on the skin, can cause contact burns. ...
- Decreased blood pressure. ...
- Increased heart rate. ...
- Increased swelling and inflammation.
Don't apply a pad to damaged skin, open wounds, or any area with nerve damage. Never use a heating pad with a cracked electrical cord.
Do not leave your heating device unattended or use while sleeping. Always turn the device off and even unplug it before going to sleep at night. To reduce the risk of overheating and starting a fire, don't use a heating pad with an extension cord or power strip.
Why can't diabetics use heating pads?
Heating pads, electric blankets, hot water bottles, or even extremely hot baths can all be relaxing and soothing, but for someone with diabetes, they can be dangerous. If you already have nerve cell damage, you may not be able to tell how hot a heating pad is, and you run the risk of burning your feet.
No, in most cases anti-inflammatory drugs (like ibuprofen or naproxen) don't help healing. In fact, in some cases it may even delay healing.
The problem with using ice as a vasoconstrictor is that, while it limits blood supply and therefore reduces swelling, it also limits arrival of immune cells and thus interferes with core parts of healing.
As soon as possible after an injury, such as a knee or ankle sprain, you can relieve pain and swelling and promote healing and flexibility with RICE—Rest, Ice, Compression, and Elevation. Rest. Rest and protect the injured or sore area.
Nerve Pain
It's best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.
Soothes nerve endings: Heat sedates and soothes irritated nerve endings, providing quick relief from pain and discomfort. Improves blood flow: Heat increases blood flow to the affected area, bringing more oxygen and nutrients to the injured tissues while flushing out waste products and damaged debris.
Heat calms painful muscle spasms
Heat therapy can help relieve tightness in the lower back by recouping circulation, relaxing tense muscles, and reducing related pain.
Once the inflammation calms down, heat can help relax any tense muscles near the pinched nerve. Heat can also stimulate blood flow, which can aid in healing. Try using a heating pad or a warm compress. As with ice, you should protect your skin from direct heat.
Rule of thumb for most injuries: Ice first, heat later. But avoid using them in tandem except as directed by a health care provider, Jake said. Most injuries cause your body to react with inflammation and swelling. Ice is used to cool down the injured joint or tissue and reduce swelling.
Heat therapy. Applying heat to an inflamed area will dilate the blood vessels, promote blood flow, and help sore and tightened muscles relax. Improved circulation can help eliminate the buildup of lactic acid waste occurs after some types of exercise.
Is ice or heat better for sciatic nerve pain?
Alternating heat and ice therapy can provide immediate relief of sciatic nerve pain. Ice can help reduce inflammation, while heat encourages blood flow to the painful area (which speeds healing). Heat and ice may also help ease painful muscle spasms that often accompany sciatica.
Heat dilates, or widens blood vessels, allowing more inflammation to flow to an injured or painful area.
Neuropathy — like most chronic pain — often gets worse as temperatures drop. Blood flow slows in your outer extremities when your body is exposed to cold. Nerve pain — especially in your hands and feet — increases as your circulation decreases.
The main medicines recommended for neuropathic pain include: amitriptyline – also used for treatment of headaches and depression. duloxetine – also used for treatment of bladder problems and depression. pregabalin and gabapentin – also used to treat epilepsy, headaches or anxiety.
As you may have guessed from the descriptions above, acetaminophen is best used for fever, aches and pains, but will not be very helpful if the pain is due to inflammation. Ibuprofen is more helpful for these symptoms when inflammation is the cause.
Heat therapy can help ease acute and chronic back pain. A person should apply heat to their back to help relax the muscles, reducing pain. Applying heat to the muscles can cause the blood vessels to dilate, improving circulation. This promotes the healing of any damaged muscle.
Sleep on your back with a pillow under your knees
For some people, sleeping on their back may be the best position to relieve back pain: Lay flat on your back. Place a pillow underneath your knees and keep your spine neutral. The pillow is important — it works to keep that curve in your lower back.
Chiropractic is a great way to relieve pinched nerves – and it's something we can do for you today. Professional Chiropractors have an intimate understanding of the body and the nerves, and know where to apply pressure to reduce pain, relieve tension, and hasten recovery.
Research Shows Why Massage Can Help With Pinched Nerves
Try a gentle, relaxing Swedish massage, which will loosen up your tense muscles and may release the pressure around your nerve. You probably want to avoid deep tissue massage, since the deeper pressure may make the problem worse.
- Resting the Affected Area. When you have a pinched nerve giving yourself time to rest is important. ...
- Applying Ice. ...
- Using Heat Therapy. ...
- Stretching and Exercises. ...
- Physical Therapy. ...
- Chiropractic Care. ...
- Massage Therapy.