• Preya Ramdass. PT

HEAT VS. COLD – The Great Debate in Recovering from an Injury!

Updated: Oct 2, 2019

HEAT VS. COLD – The Great Debate in Recovering from an Injury!

The debate about heat vs. cold is never ending. The question over when to use heat vs. cold continues to be one of those questions that I get repeatedly from my patients. Why, When & How to use heat vs. cold is discussed to help you here.

Before I start, I totally understand that no one wants to have anything to do with ice in February and the last thing you want in August is apply more heat. Heat vs. cold is something I don’t enjoy telling patients to do so either. Ice seems cold, mean and uncomfortable. Heat seems warm, comfy and cozy. Here are some answers about heat vs. cold that I hope will make more sense to you. Here is some helpful information when deciding between heat vs. cold:

ROUND ONE: Heat vs. Cold


HEAT: The purpose of using heat includes increases in blood flow, metabolism, and elasticity of connective tissues, therefore, reducing pain. In other words, by increasing the temperature and improving circulation, heat can relax injured muscles, heal damaged tissues and improve flexibility

ICE: The purpose of using ice includes a decrease in blood flow, edema, inflammation, muscle spasm, and metabolic demand, therefore, reducing pain. In other words, calming down damaged superficial tissues that are inflamed, red, hot and swollen.

ROUND TWO: Heat vs. Cold


HEAT: Chronic pain (pain that reoccurs or persists longer than 3-6 months) such as arthritis, stiff joints both spinal & peripheral, chronic inflammation of a tendon, and tight muscles.

ICE: Acute pain (immediately after an injury and up to 6 weeks after but most helpful in the first 72 hours) such as a sprained ankle, post surgeries, sudden onset of low back pain, and acute inflammation of a tendon.

ROUND THREE Heat vs. Cold


HEAT: Apply to the painful area for 15-20 minutes several times each day. For heat therapy, the use of a hot water bottle, pads that can be heated in a microwave, or a warm bath.

ICE: Intermittent icing (10 minutes ice, 10 minutes room temperature, 10 minutes ice, every 2 hours) for acute injuries. For cold therapy, a water bottle filled with cold water, a pad cooled in the freezer or cool water can be used.

When applying heat vs. cold, be sure to wrap whatever you are using in a thin towel to help protect your skin. It is normal to notice some skin changes after using both heat or cold. Heat or cold please allow your skin to return to its normal temperature and colour before applying heat or cold again.

In some cases, alternating heat and cold may help, as it will greatly increase blood flow to the injury site.

Please keep in mind that the above is only a recommendation and research in this is area remains controversial. To ensure you have the best treatment plan for your needs, click here to book with PR Physiotherapy.

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