What’s the big deal, right? Well – both heat and ice therapy are successful in assisting treatment of musculoskeletal issues. Ranging from sprains, strains, delayed onset muscle soreness (DOMS), knots, end of day back ache and more – these two modalities are effective and can help you achieve relief.
After an acute injury – patients will often tell me that they used heat or ice, and are confused as to which one they should be using. While both are great – they each have their place in the healing process. It is not a case of “is heat or ice better?” but more of “when during my healing should I use heat versus ice?” Let’s break down the pros and cons of each modality before going any further.
HEAT:
Otherwise known as thermotherapy, is defined as the application of a heat to an injured or painful area for relief and minimizing stiffness. By making use of a microwavable bean bag, hot water bottle or an electric heat pack – the idea is to warm up the affected area for 20 minutes. You can expect a slight redness to appear on the skin but be careful not to let it burn.
Benefits | When NOT to use thermotherapy |
Pain relief | Impaired circulation |
Muscle relaxation | Open wounds, infected tissues, other skin diseases |
Enhances collagen extensibility | Bleeding or hemorrhaging areas |
Decrease Swelling | Inability to detect heat (this can lead to a burn) |
Promotes blood circulation | |
COLD:
Another name for this modality is cryotherapy. Here, ice packs or even just regular ice are applied to the affected area to help stimulate oxygenated blood flow, decrease inflammation, and reduce pain. Be careful not to let the ice burn your skin. You can ensure this doesn’t happen by wrapping the ice in a towel and only keeping it on the painful region for 10 – 20 minutes. Once again you can expect the skin to go red.
Benefits | When NOT to use cryotherapy |
Pain relief from injury | Certain cardiac conditions |
Reduce muscle spasm/ spasticity | Cold insensitivity |
Decrease swelling | Vasospastic Conditions (such as Raynaud's) |
Decrease local blood flow temporarily | Peripheral nerve injuries (such as diabetic neuropathy) |
Promote faster healing on athletic injuries | Peripheral vascular diseases (such as peripheral artery disease) |
Arthritic relief | |
RIGHT, SO?
If you choose to not make use of pharmacological aids to reduce pain and promote healing - both hot and cold therapy provide pain relief, so how do we choose which one to use? Randomized clinical trials have found that both are effective, although heat is more successful than ice when it comes to muscle soreness. That being said, ice is more effective in the initial 48 – 72 hours after an acute injury such as a sprain or strain. After that period, studies have shown that ice has little effect and heat should be used instead. For an injury such as low back pain, heat should be used throughout the treatment process.
During treatments at The Chiro Lab, my patients know that I adore using thermotherapy. One of the first things I do during treatment is pop a heat-pack into the microwave and get it ready for my patients to enjoy not only the warm and fuzzy feeling, but also reap the physiological benefits of heat.
If you want a natural, non-pharmacological and safe approach to treating your condition – chiropractic should be your first choice. Through using a hands on approach, your chiropractor can help you with a wide variety of conditions. Not only will you feel better when you finish with your appointment – but you will receive advice and information on how to improve your condition, and if you should be using heat or ice.
If you have a preferred modality - share your tips and tricks in the comments below!
Malanga, G.A., Yan, N. and Stark, J., 2015. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate medicine, 127(1), pp.57-65.
Nadler, S.F., Weingand, K. and Kruse, R.J., 2004. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician, 7(3), pp.395-400.
French, S.D., Cameron, M., Walker, B.F., Reggars, J.W. and Esterman, A.J., 2006. Superficial heat or cold for low back pain. Cochrane Database of Systematic Reviews, (1).
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