From your health and wellness experts at Prisma Health
Health, Orthopedics

Should you use ice or heat for injuries?

Palmetto Health-USC Orthopedic Center
Ice packs and heating pads are common ways to control pain from orthopedic injuries. But which one is right for your injury? And how long should you use it? Kyle Arthur, MD, Palmetto Health-USC Orthopedic Center, explained.
“Both cold and heat have advantages and they work best in different scenarios,” said Dr. Arthur. “They can be administered at home with a few simple safety precautions.” 

Cold therapy

Cold exposure triggers a tightening of blood vessels to restrict blood flow in very small arteries. Decreasing blood flow in small arteries to an area of injury will minimize inflammation and swelling, which decreases pain and helps maintain function at the site of injury. Using cold therapy at home can be accomplished easily with a few simple steps. 
  • Use a bag of ice, a pre-made cold pack, or even a bag of frozen vegetables. 
  • Wrap the ice pack in a small towel or cloth to protect the skin from direct contact. 
  • Apply the cold source directly at the site of injury. 
  • Cold therapy can be used for 15-20 minutes to treat the soft tissues. 
  • This can be repeated every 1-2 hours, as long as you allow time for the tissues to warm up after treatment. 

Heat therapy 

Heat therapy results in increased blood flow to the area through a widening of small blood vessels within the tissue. Increased blood flow and warming tissue can relax muscle tension and improve flexibility. Using heat is just as easy as cold therapy. 
  • The source of heat can be a warm water bottle, a hand towel soaked in hot water, or even a pre-made hot pack.
  • Once again, you should use a barrier to protect the skin from the source of heat and prevent burns. Heat therapy can be used for 10-20 minutes to treat tight muscles and pain. 
  • Heat can also be repeated every 1-2 hours if needed.
In addition to affecting blood flow and tissue response, both heat and cold therapy can decrease the firing of pain receptors. “This can provide an immediate form of pain relief to an area of injury on top of the benefits at the tissue level,” Dr. Arthur said. 

When do you use it?

Typically, cold therapy is used in the first 48-72 hours after an injury to minimize inflammation and control pain. Cold therapy is also beneficial to an old injury or chronic pain by decreasing firing of local pain receptors. 
Heat therapy is used after the first 72 hours of an injury or for chronic pain, especially those related to tight muscles or tendon injury. 
“Either heat or cold can be used for most pain and if one works better, you are not wrong to keep using it,” Dr. Arthur said. “Some even find relief by alternating between cold and heat therapy.”

Learn more

If you have pain from an orthopedic injury, we’re here to help. Schedule an appointment online at