By Ashley Williams

When treating joint or muscle discomfort, we often gravitate towards heat or ice to help soothe the pain. There are some scenarios where heat may be a better treatment option over ice, and vice-versa. How do we know when to apply heat to an affected area? When should we apply ice? These differing treatment options should be used to optimize your overall treatment.

Heat is used to dilate blood vessels and promote circulation to a specified area. Increased blood- flow can relax the tension and restore damaged soft-tissue. Ultrasound, used as a therapeutic modality, can promote a deep heat within the tissue. Unlike cold therapy, heat therapy works best when applied for longer periods. A heating pad can be used to treat stiffness or tension in just 15- 20 minutes. For moderate to severe pain, a long-heated bath or shower can relieve whole-body ailments.

Heat therapy should not be used alongside signs of bruising or swelling. It is also a lousy treatment option on any open wounds. Certain pre-existing conditions could make you more prone to burns or complications. These include: diabetes, dermatitis, vascular disease, deep vein thrombosis, and multiple sclerosis.

Cold therapy is mostly used to reduce inflammation and swelling, but can also be used to reduce hyperactivity of a nerve. It accomplishes this by restricting blood- flow. The most common form of cold therapy is the use of an ice pack, or frozen vegetable substitute. When using frozen materials, it’s important not to place them directly on your skin. All frozen materials should be wrapped in a thin towel or pillow case. Cold treatment is most effective when used directly after an injury. This helps to control early onset of inflammation. Contrary to heat therapy, cold treatment time should be monitored.

Cold should only be used for 10-15 minutes at a time; too much exposure can cause skin and tissue damage. Cold treatment should not be used on anyone with a sensory disorder. This disorder prevents them from feeling skin or tissue damage. Over exposure could lead to worsened nerve damage.
Knowing when to use heat or ice can increase the effectiveness of your treatment. Every condition is different, and may require a distinctive treatment approach. Talk to your therapist about which treatment plan is most appropriate for you!

1. Gotter, Ana. “Treating Pain with Heat and Cold.” Healthline, Healthline Media, 8 Mar. 2019,