Ice or heat when in pain?

Ice or heat when in pain?

ice or heat on pain

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One question physical therapists often ask is whether to use ice or heat on an injury. Here are some general guidelines to help in many situations. If you have certain conditions, such as fibromyalgia, reflex sympathetic disorders (RSD), or rheumatoid arthritis, your sensory pathways are affected and don’t fall into typical response patterns.

Ice is for injuries and after activity and heat is for loosening and relaxing tissues, used before activity.


  • First 24 – 48 hours after one onset of acute injury, Use ice. It is also perfect for simple muscle sprains or strains.
  • Use ice after an activity, at the end of the day or when swelling is present. When things get inflamed, the more you do it throughout the day, the more inflamed the area will get. Ice will help reduce pain, swelling and inflammation.
  • Ice can also be used for chronic conditions such as overuse injuries to help control swelling.

Ice Methods:

  • ice cubes in a plastic bag
  • wet, wadded towel
  • gel ice pack

Things to know about icing:

  • Do not apply ice for more than 20 minutes
  • Allow your tissue to re-warm completely before re-icing
  • 20 minutes on, 40 minutes off is a good rule of thumb for icing at times
  • If you are applying ice to an area with superficial veins (elbow), do not apply ice for more than 10 minutes
  • You never want to add ice before an activity. You want to warm up your muscles, not cool them down!
  • Ice can aggravate the symptoms of stiffness and tightness.


  • Heat is usually used to help relax or loosen the tissues.
  • The heat will bring more blood flow to the area.
  • Heat is usually used in conditions that are more chronic. This helps stimulate blood flow to the area.
  • Heat, when necessary, is used prior to activity aiding greater blood flow to help loosen and relax muscles.

Warming up methods:

  • hot seat
  • warm, wet towel

Things to know about heating:

  • avoid prolonged heating
  • Do not use heat while sleeping to avoid burns
  • The heat can make the swelling much worse.

If your pain doesn’t subside after a few days, don’t hesitate to reach out and ask for help. We can evaluate your injury or pain and get you back on the road to recovery.

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Looking for an ice pack and can’t find one? do not worry. Making your own ice pack at home is practical and easy.

hand in ice pack


  • 2 cups water
  • 1 cup rubbing alcohol
  • Gallon-sized Ziploc bags


  • Add water and rubbing alcohol to the bag ** Double the bag for added protection from breakage.
  • Close the bag, removing as much air as possible.
  • Place the bag in the freezer until the liquid reaches a mushy mixture.
  • When ready, wrap the bag in a towel or pillowcase before applying to the skin. (Do not apply the bag directly to the skin)

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Editorial Staff

Editorial Staff is a team ofc physiotherapist: expert writer, editor, proof reader and content researcher who mind storm their brain to bring helpful educational and informational articles for readers of

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