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Quick Guide: When to Use HEAT vs. ICE

8/17/15 12:46 PM
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When to use ICE:
  • Ice, or a cold pack, is commonly used following trauma, such as surgery to help reduce swelling and decrease pain.
  • Ice can and should be applied following acute injuries, such as an ankle sprain, in the first 24-48 hours when swelling is persent. Ice is a vasoconstrictor, meaning that it closes off blood vessels and can help to decrease the swelling.
  • Ice also has a numbing effect. Therefore, it can also help to reduce pain. 

How long should you ICE for?

 

The quick answer is roughly 15-20 minutes, but this does vary for each individual. There are 4 basic phases of icing that you will experience once you put the ice pack on....

  1. Cold - Initially when the ice is placed on the body, it will feel just plain cold.
  2. Burning - The next phase you are likely to feel is that slight burning sensation.
  3. Aching - This is almost a painful ache as the ice has been on the body longer.
  4. Numbness - At this phase, the ice should be removed from the body part.

 

When should ICE not be used?

 

  • By those who have Raynaud's disease
  • On areas of decreased sensation
  • By those with Rheumatoid arthritis
  • By those with Cold Uticaria (or a cold allergy)

 

 


 

 

Now for HEAT, when should you use it?

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  • Heat can be used for more chronic or long standing injuries.
  • As opposed to ice, heat is a vasodilator, meaning that it opens up the blood vessels and helps to increase bloodflow to an area. Therefore, you don't want to use heat immediately after an injury that is swollen as you this will increase the inflammation and delay healing.
  • Want some examples of when heat is a good idea? Muscle spasms, arthritic conditions, after the acute and subacute phases of surgery or injury have passed ( such as wehn trying to stretch and gain range of motion)

 

How long should you HEAT for?

 

 

Heat can also be applied for anywhere between 15-20 minutes. If you feel as though the heating pad is too warm, be sure to add an extra layer so you don't burn your skin. A towel works nicely to add that layer.

 

When to NOT use HEAT:

 

  • Immediately after surgery or when swelling is present. (See the above section on ICE!)
  • During the acute phase following an injury.
  • On areas of decreased sensation, unless you can closely monitor and observe the area to make sure the heat is not causing tissue damage.
  • Areas of local malignancy (cancers)
  • Areas where there is a known DVT or blood clot.

 

 

For more specific questions regarding other injuries or conditions, feel free to Ask a Physical Therapist! Click the "I have a question" button below to have your question answered by our team of Physical Therapists. 

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Written by Jeffrey Romans.

Jeff Romans, PT is a contributing author to our blog and a great resource on Physical Therapy.

Topics: Insider, tips