Heat or ice: which is best for your pain or injury?

Earle Logan

28 July 2015

Why do we turn to heat or ice?

Cold and heat therapies are an easy, natural and inexpensive ways to help relieve pain, so it’s little wonder they are so popular.

They are generally very efficient at their job, and understanding which is the best one to use for particular pains and aches can help you ease soreness, stiffness, swelling and inflammation faster, as well as prevent them from getting worse.


Whether it be wrapping up warm in the winter, taking a warm bath or using a hot water bottle wrapped in a towel, heat is used in situation where circulation is poor. Heat causes the blood vessels to dilate (open up), which stimulates blood circulation to help heal damaged tissues. The warmth also helps to relax sore muscles, ease muscle spasms and stiffness, as well as alleviate pain.

When to use heat

For chronic problems – such as pains which have lasted for at least a week or for muscle and joint conditions that affect people’s lives for months or years, such as arthritis, fibromyalgia or sciatica- apply heat. Circulation in these conditions is often compromised because of scar tissue, compressed blood vessels or crushed nerves. Heat also helps to ease chronically stiff joints e.g. long-standing neck pain and back pain.

Cold fingers – heat improves blood flow by relaxing the tiny muscles that constrict blood vessels.

Muscle stiffness (without swelling) e.g. after exercise or fibromyalgia – heat improves blood flow, improving flexibility and so reducing injury.

Joint pain and/or stiffness (without swelling) e.g. arthritis and stiffness first thing in the morning – heat helps the tendons and ligaments improving flexibility, which helps ease joint pain and stiffness.

Injured areas after the swelling has gone down e.g. wrists or ankles – heat relaxes the muscles in the area that may still be tense, improving flexibility.

Trapped nerves – heat stimulates nerves and improves their blood supply.

Prior to physical activity – applying heat before activity stimulates blood flow, warming up muscles and making tendons more flexible, which helps to reduce the risk of injury and ongoing problems.

How to apply heat

There are many different ways heat can be applied including hot water bottles, heating pads, heated gel packs, heat wraps, wheat bag, heat creams, warm shower, sauna or a long soothing hot bath.

Tip: The heat should be warm, not excessive. Don’t apply heat for longer than 20 minutes and if applying directly to skin, make sure you protect your skin from burns or scalds by wrapping a thin towel around any heat device.


Cold therapies such as ice packs or ice baths are used when swelling and redness are present due to increased circulation. Using cold/ice as a treatment can help to reduce swelling by constricting blood vessels (reducing circulation) and although often uncomfortable at first, it can also numb pain.

When to apply cold/ice

For acute conditions – acute pain is that which appears suddenly but eases after a day or two, perhaps a week if you have really overdone the new exercise routine or fallen and hurt yourself. Bear in mind that pain might initially be experienced whilst working hard, as lactic acid builds up. This will have cleared soon after stopping.

The pain experienced in the 12-48 hrs following over-exertion is due to many very small injuries to the muscle fibres or to the tendons that attach the muscles to the bones. Blood rushing to the area causes inflammation, redness and tenderness, therefore cold is used to reduce blood circulation.

Injury (with swelling)  such as sprains or muscle strains – use immediately after an injury. Cold keeps swelling reasonable so you can still use the area, therefore maintaining movement.

General inflammation or tenderness – the swelling that occurs with inflammation is also accompanied by pain. Cold helps numb sharp pain and reduce inflammation.

Muscle soreness after exercise – cold baths for muscles or cold applications for joints mean you’ll be back in action sooner, as this helps to lessen wear and tear of muscles and joints.

Burns – cold helps preserve damaged tissue and reduces nerve pain.

Gout – ice can help calm gout flare ups and numb pain.


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  • Toko mazvimbakupa's photo avatar
    Toko mazvimbakupa — 22.07.2018 03:19
    I like your natural treatment to muscle pain. Are there sude effects of using hot water bottle for muscle pain


  • jacquii Thomas's photo avatar
    jacquii Thomas — 06.06.2017 06:05
    Ice packs are good for muscles pain hot or cold.


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