Ice or Heat for Pain?

This is a common question in my office. When you’re having pain, is ice or heat better?

The answer is, it depends. There’s the general rule of use ice for new injuries and heat for old injuries. However, sometimes pain can be new, yet respond better to heat.

If you are having pain due to a new injury, and that injury has caused redness, bruising, swelling, or you think you “tore” tissues (like in a severe ankle sprain), use ice. When using ice, to be most effective you need to keep ice on the area until it goes completely numb. For body parts that have less muscle and fat, that might only take 10 minutes. For other areas like the low back, it may take 20 minutes. Once it’s numb, remove the ice and keep it off until the area warms completely. Overdoing it with the ice will cause the opposite effect and actually can produce more swelling, or may cause damage from frostbite. Ice is best for tissue damage and swelling because 1)it ‘numbs’ pain nerve fibers so you’re more comfortable and 2) it causes blood vessels to constrict and reduces swelling and pain from chemicals released by the body in response to the injury.

Other than pain resulting from tissue damage (redness, swelling, bruising, etc.), ice or heat can be used. I usually recommend using ice for 10-20 minutes, then heat 10-20 minutes, alternating back and forth as often as possible. That usually works very well for pain caused by muscle spasm or tightness. The ice numbs the pain fibers and reduces any inflammation present by constricting blood vessels, and the heat opens up the blood vessels and brings fresh blood to the area along with oxygen and nutrients needed to heal the injury. Once pain is minimal, usually just using heat is best. Heat relaxes tight muscles and improves circulation, reducing pain and promoting the healing process.

Other than alternating ice and heat, sometimes it’s best just to use one or the other. Try both and see what feels better. In general, severe pain responds best to ice and mild pain responds best to heat. Also, pain from muscle tightness usually responds best to heat. Moist heat, like that from a hot bath or shower or a moist heating pad, is preferred over dry heat, like heat from dry sauna or regular heating pad. Moist heat penetrates better and is less likely to irritate the skin.

USE CAUTION when using ice or heat. Icing too long can cause frostbite. Using something too hot can cause burns. Never fall asleep with either on the body. If you are going to use a heating pad in bed, make sure it has a timer that shuts off after a few minutes.

In regards to the icy hot pain patches and lotions such as Biofreeze, Sombra, and Tiger Balm, although they do not do the same thing as ice and heat, they are a great alternative for when you can’t use ice or heat (like when you have to be at work or go out of the house). Just be very careful using these lotions around the same time as using ice or hear. Do NOT use them at the same time. The active ingredients from the lotions may interact with the ice and heat and cause skin irritation and burns. I had one patient use Tiger Balm and then get a hot shower. It causes blistering similar to severe sunburn. He won’t make that mistake again.

Finally, although these methods are great for pain and can help keep you comfortable, if you have an issue that persists more than a few days, you should probably have it evaluated by your chiropractor . We can find out what’s causing the pain and treat it in the office to reduce your recovery time, as well as give you specific recommendations of what can be done at home to speed the process along.

If you’re in the Orwigsburg or surrounding areas in Schuylkill County, and you’re having an issue, you can give us a call at 570-366-2613. Check out our website for more information at Blue Mountain Family Chiropractic

(Dr. Touchinsky is a chiropractor in Orwigsburg, Schuylkill County . In addition to treating people for neck pain and back pain, he focuses on helping people overcome a variety of health issues through healthy lifestyle and nutritional counseling. If you have an issue you’d like help with or would like a second opinion, call the office at 570-366-2613 to set up an appointment.)

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