Therapeutic icing and heating, also known as cryotherapy and thermotherapy, are simple, affordable and safe treatment options for many common aches and pains. But knowing which one to use in which situation can be confusing sometimes. This article will help you make sense of things and even answer some questions you didn't even know you had.

Cryotherapy (Ice)

In general, ice is for "fresh" injuries and acts as a simple numbing agent to temporarily relieve pain. After an acute injury, the body produces an inflammatory process around the injured tissues which causes swelling and pain in an effort to discourage you from moving the area and making the injury worse. The inflammatory process is normal and is a natural part of tissue healing and repair. But sometimes, the pain produced is disproportional to the actual tissue injury, especially in the early days. So ice is a great, drug-free option for that first 24-72 hours after an injury.

Some examples of when to use ice:

  • Rolled ankles
  • Pulled muscles
  • Runner's knee
  • Moderate to severe bruising
  • Plantar fascitis
  • Tennis elbow
  • Shin splints
  • Arthritis

As for how much ice to use, you're going to need more ice for areas with more tissue mass like the thighs or low back because the cold is going to take longer to reach the deeper tissues that are injured. But more superficial areas like the shoulder or knee may only require a single ice cube to experience the positive benefits of ice. As for how long to ice, 20 minutes is the typical recommendation but it's better to follow the rule: "When you're numb, you're done."

Thermotherapy (Heat)

Heat is more effective for stiff or achy muscles or those "knots" that you may feel in your back or neck. Heat works well by not only alleviating muscle tension but also by relieving stress, anxiety and sensitization by calming the mind and the nervous system. In general, heat is better for more chronic soft tissue complaints rather than acute injuries. If you can't recall a specific event that triggered the pain you're experiencing, then heat is probably your best bet.

Some examples of when to use heat: 

  • Muscle stiffness
  • Cramps
  • Trigger points or "muscle knots"
  • Dull and persistent pains
  • Fibromyalgia

Heat can be used to help with an acute problem but is typically not recommended for the first 24-72 hours after the initial injury and in some cases can make the pain worse. Pain and swelling will be at their peaks during the first few days so ice is more appropriate during this time to take the edge off. Switching to heat is usually better when the injury has calmed down.

The Bottom Line

The effectiveness of ice and heat on muscle injuries and pain is mixed and it is in no way a miracle cure. However, both therapies are a safe and drug-free option that you can use to manage your aches and pains at home. With this in mind, everyone is different and what works for some may not work for all. If you start to use ice or heat and you don't like the feel of it, just switch to the other option. Whatever makes you feel better is what is most important!

Dr. Andrew Caroon

Dr. Andrew Caroon

Contact Me