Benefits of Ice and Heat
Ice has long been used in an effort to manage swelling and pain for both acute and chronic injuries, aches, or pains. Cryotherapy is the term for all modalities and
treatments involving the use of cold to improve pain and function. Treatments such as ice baths, ice massage, ice packs, or even cold rooms, are all different types of
cryotherapy that are commonly used. Ice therapy is so ubiquitous that there is a
mnemonic used for remembering how to treat acute injuries such as an ankle sprain:
RICE - Rest, Ice, Compress, Elevate.
Ice primarily works by constricting the blood vessels in the area that the ice is applied. This leads to a reduction in blood flow and subsequently in all the inflammatory cells that help create swelling in an area. Ice additionally increases your pain threshold and pain tolerance while decreasing nerve conduction velocity.
Ice can be a beneficial tool in pain reduction when used appropriately. For people with chronic pain, ice can help decrease pain and swelling when used for 15-20 minutes at a time. Prolonged use of ice can cause damage to your skin and can have detrimental effects to healing due to the prolonged reduction in blood flow. Shorter use of ice may not allow for the area to be significantly cooled to provide therapeutic effects.
Generally speaking, if your injury occurred in the last 3 days, ice is preferable to heat. Ice has been shown in studies to reduce pain, improve range of motion, and improve function. However, the effect is usually small and the research supporting it is very limited.
An alternative to ice is the use of heat. There are many different methods for heat treatment such as ultrasounds, moist hot packs, saunas/steam rooms, laser
treatment and more. Generally heat is used to increase blood flow to an area which helps provide nutrients for repair as well as flushing out debris and lymph to allow for optimal healing. Heat can also help improve tissue elasticity and reduce pain and stiffness which allows people to move better and complete all the tasks they have for the day.
Heat should not be used immediately after an injury as it will promote further swelling and inflammation in the area. Once out of the initial inflammatory stage (2-3 days), heat can be applied to help manage and reduce pain while increasing function.
Both heat and ice have been shown to have short term improvements in range of motion, pain, and function, but neither one has strong evidence that it will improve your injury in the long run. Generally, there is no best answer for what is best to use when having pain. The best modality is the one that helps you feel the best. The ideal course of action is to be seen by a medical professional to assess and treat your specific injury. A physical therapist can help answer any specific questions you may have and put you on the shortest road to recovery.
Author: Edgar Vargas, PT, DPT
Dr. Edgar Vargas, PT, DPT received his Bachelor of Science degree in Kinesiology with emphasis on Exercise Science from California State University, Long Beach graduating Cum Laude. He later received his Doctorate in Physical Therapy from Chapman University. He has clinical experience in a variety of inpatient and outpatient settings including orthopedic and neurologic. Through his treatments, Edgar aims to treat the patient as a whole by listening to and understanding the individual needs of the patient. He seeks to educate each patient so that they may become confident in managing their conditions.Outside of the clinic, he spends his time rock climbing, traveling, and relaxing with his family and friends.
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