Treat Pain with Cold or Heat?

Q: When Do I Apply Heat And Cold To An Injury?

You should use cold therapy while the injury is still acute , and then heat therapy when it has started healing, or has become chronic . You can use both in the same rehab routine, in the following manner: Wearing A Brace / Support Heat Therapy Massage Movement Exercises Stretches Strength Exercises Cold Therapy

Using Heath Therapy, or Cold Therapy is done at different stages of a typical rehab programme. Learn when it’s best to use each.

In This Article:

Heat Therapy Or Cold Therapy?
Cold Therapy For Pain Treatment
Heat Therapy For Pain Treatment
Which Order? Use Both Treatments…
Frequently Asked Questions
Further Reading & Resources
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Heat Therapy Or Cold Therapy

Physical Pain Treatment should be done with Hot or Cold Therapy? Which is best??

I reckon we could ask 100 different therapists and we would get completely different answers.

Why is this?
Why is it so complicated?
Should I heat first or ice first?
Should I not use heat at all?

One patient we have, has suffered from plantar-fasciitis for 18 months. They have spent a small fortune getting treatment, between deep tissue massage, physiotherapy, arch supports, acupuncture, anti inflammatories. Most recently they have spent €300 on custom made orthotics. All while spending hours heating and icing their sore foot.

Another patient we have been treating started out with an Acute Neck Injury. Through neglecting it, and obtaining the wrong therapies (self-researched on the internet), this problem has progressed. He now has a Chronic Neck problem, exacerbated by his lifestyle of working and commuting, which needs constant treatment to keep it right. This is how an Acute condition can progress to a Chronic Back Pain Condition.

Cold Therapy For Pain Treatment

Applying cold to an injured area quickly constricts the local blood vessels, reducing blood flow. It also slows the growth of inflammation, swelling and ultimately tissue damage. This is why it’s so good for quickly applying to an acute injury.

It also numbs the area somewhat, which might provide some initial pain-relief. Cold and Ice can help reduce the swelling at the joint or muscle. It is most effective within 48 hours of an injury.

Heat Therapy For Pain Treatment

Heating an affected area does the opposite – dilating the blood vessels and promoting blood flow. Crucially, it can make the muscles in the area relax which may help a lot with the injury itself.

Heat can FEEL better too – not as effective at blocking pain as cold, but if you are treating a non-acute injury, it will definitely feel much better. For certain problems, heat should always be used – for example, it’s usually better than cold at treating arthritic conditions. Fibromyalgia sufferers have reported benefits from heat too!

Which Order? Use Heat & Cold Therapy!

So my advice is to ice the initial injury for the first 24-48 hours, maybe more to reduce swelling and also has an analgesic effect.

When swelling has reduced and pain has calmed down, applying heat works better after that time period before starting exercise programmes.

You start our exercise plans with 10 minutes of heat applied to the affected area before commencing the massage, movement, stretching and ultimately strengthening – as part of our overall treatment programme. Remember to always consult the professional who is treating your condition before embarking on any course of action!

It can work for you! Let’s get started…

Frequently Asked Questions:

Is Heat Therapy Good For Injury?

Once the initial phase of injury has subsided, and swelling has gone down, you can use Heat Therapy to warm back up the muscles and connective tissue, before engaging in your rehab exercises. Heat also promotes blood flow to the area, which helps the body to heal.

Is Cold Therapy Good For Injury?

Cold therapy can be beneficial at the initial stage of injury – straight after it has occurred. You’ve all seen athletes icing their swollen limbs, and this is because cold can bring swelling down, and also provide some primitive pain relief. Only after the swelling has subsided should you consider moving to the next stage of your therapy.

When Do I Apply Heat And Cold To An Injury?

You should use cold therapy while the injury is still acute, and then heat therapy when it has started healing, or has become chronic. You can use both in the same rehab routine, in the following manner:

Wearing A Brace / Support
Heat Therapy
Massage
Movement Exercises
Stretches
Strength Exercises
Cold Therapy

How Long Should You Ice An Injury?

Initially you should ice the area on and off for 10 minute periods, until you can feel the swelling go down – which might take up to an hour. Cold Therapy can restrict blood flow to the area, so you don’t want to do it for too long – it’s more to bring down the initial pain and inflammation. Next step would be to get a professional to look at it, and a diagnosis.