Should I ice my injury or put heat on it? It’s a common question we receive from patients but in order to answer it we first need to understand how each of these treatments work on the body.
Cold therapy, also known as cryotherapy, is used to decrease the temperature of the skin and adjacent tissue . The most common method of achieving this is using ice packs, however there are a variety of methods used including ice baths and cold compression cuffs. When cooled, the local blood vessels constrict and slow down blood flow to the tissues which in turn slows down the rate of inflammation and swelling . Cold therapy is also beneficial for pain relief as low temperatures limit the conduction of nerves that are used to send pain signals to the spinal cord. This results in a numbing effect, similar to a local anaesthetic, is referred to as cold-induced neuropraxia [1,3].
Heat therapy on the other hand is used to increase the temperature of tissues, commonly via a heat pack, however there are a variety of other methods including hot baths and ultrasound therapy. In contrast to cold therapy, heat results in dilation of the blood vessels and increased blood flow which helps to promote healing by supplying the injured tissue with more nutrients and oxygen [4,5]. Additionally, heat can stimulate an increase in elasticity of soft tissue and help improve joint and muscle range of movement . Heat therapy also provides pain relief by interrupting pain signals sent to the brain, and it is thought the psychological comfort of heat plays a role in reducing the feeling of pain .
Like any treatment, heat and cold therapy can cause complications if used inappropriately. Cold therapy can result in frostbite, skin burns and nerve damage especially when applied incorrectly and ice should never be applied directly to skin .
Heat therapy should be used cautiously if you have diabetes mellitus, multiple sclerosis, rheumatoid arthritis and poor circulation as it can lead to burns, skin ulceration and increased inflammation [1,4]. Make sure to monitor your skin during when using heat to ensure there is no excessive redness.
So which one should I use?
To keep things simple we recommend using cold therapy for acute injuries with inflammation, and heat therapy for general muscle or joint pain and stiffness.
If you have any questions regarding your pain or injury, please give us a call at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.
Nadler, S. F., Weingand, K., & Kruse, R. J. (2004). The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician, 7(3), 395-400.
Ho, S. S., Coel, M. N., Kagawa, R., & Richardson, A. B. (1994). The effects of ice on blood flow and bone metabolism in knees. The American journal of sports medicine, 22(4), 537-540.
Algafly, A. A., & George, K. P. (2007). The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British journal of sports medicine, 41(6), 365-369.
Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate medicine, 127(1), 57-65.
Rabkin, J. M., & Hunt, T. K. (1987). Local heat increases blood flow and oxygen tension in wounds. Archives of Surgery, 122(2), 221-225.
Bleakley, C. M., & Costello, J. T. (2013). Do thermal agents affect range of movement and mechanical properties in soft tissues? A systematic review. Archives of Physical Medicine and Rehabilitation, 94(1), 149-163.
Chandler, A., Preece, J., & Lister, S. (2002). Using heat therapy for pain management.(clinical practice). Nursing standard, 17(9), 40-43.