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HEAT OR ICE: THE GREAT DEBATE

A picture of two fists coming towards each other, one made of fire and the other of ice
Fire versus ice

For general aches and pains, heat and ice are two of the best known home remedies for relief. However, these modalities are very different in their effect on body tissues. “Should I heat or ice my injury?” is very common question in the clinic. Both modalities are known for relieving pain, but what else do they do for you? Understanding the benefits for each therapy will help guide choices for treatment.

Ice

An abstract photo of ice crystals.

It is common to see athletes on the sidelines of sport events icing their injuries. This is because ice is best for fresh, or acute injuries. Because ice penetrates deeply and numbs the surrounding tissue, it has a strong pain relieving effect.  Additionally, tissue cooling reduces inflammation and results in constricting of blood vessels, which decreases development of excess swelling to a new injury.  However ice also reduces tissue mobility, so it is often not recommended after the acute phase of an injury (beyond 48 hours).  Some recent studies have even suggested that ice can be counter-effective for muscular injuries.If you do ice an injury, it should be applied for no more than 20 minutes to avoid tissue damage.

Heat

An abstract image of fire.

Heat is a helpful analgesic, especially for tight muscles. Applying heat causes vasodilation, the widening of blood vessels and increase in blood flow to the area.  This new influx of blood can bring more oxygen and nutrients to the tissue and promote healing. Heat also helps to loosen and relax tissue, which can reduce spams and improve range of motion – especially for tight muscles. Finally, the soothing sensation of heat can actually distract the body from pain. In the case of active inflammation or bleeding, heat is not indicated because it can exacerbate both of those issues.  Be sure to perform frequent skin checks to avoid burns when applying heat, especially if you have reduced sensation!

When it comes to heat vs. ice, many people swear by one or the other. Understanding how these modalities work will help in

deciding which is the best for you. While this article offers some guidance, there really are no hard and fast rules. In the end, if you find one of these helpful in relieving your symptoms, go with it!