I often get asked in my office which is better, heat or ice? In an effort to help guide people who are treating musculoskeletal pain on their own, I thought I’d write a piece on that exact topic this month.
The debate about heat or ice is a popular topic. A quick online search of heat vs. ice showed 1.2 billion results. Some people prefer heat, others cold. And I have patients say that either can make their pain better or worse. So, which is it? Which is best? Well, let’s have a look at the science and rationale behind heat or cold therapy.
In general, inflammatory conditions and acute injuries will be treated better with ice, or cryotherapy, especially in the first 48-72 hours. Inflammation is the body’s response to injury. Inflammation creates swelling as fluid leaks out from the smallest blood vessels called capillaries. Pain modulating and healing products are also released. Although inflammation may be painful, it allows for the body’s natural healing factors to accumulate at the site of injury.
Cryotherapy reduces swelling, decreases bleeding, pain, and can even reduce the nerve conduction of pain signals. The use of ice after an injury or surgery decreases pain and the amount of pain medicine required. Studies show that 20 minutes of icing is preferred. Icing too long can lead to frostbite and reactive vasodilation which results in increased swelling. Do not apply ice directly to skin. Take a 30-minute break between cryotherapy sessions.
Heat is typically recommended for chronic injuries or muscle pain and spasms. Heat will cause vasodilation which leads to increased blood flow to an area. This can be good for chronic muscle pain or spasms. Pain in large muscle groups can respond well to heat after the first 72 hours from injury. Use a moist heat pad for 20 minutes with a 30-minute break between sessions.
In conclusion, both ice and heat have a role to play in recovery from musculoskeletal injury and pain. Ice for acute injuries and joint pains, and inflammation. Heat for more chronic injuries especially muscle pain or spasms.
As always, we are here at Adventist Orthopedics to help you recover and get back to enjoying life! For more information, contact our orthopedic clinic at 818-863-4446 and schedule an appointment today!
Dr. Morgan