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Heat or Ice for my Injury? 6 Simple Rules to Follow

Should I use heat or ice for my injury? 6 Simple Rules to follow As physiotherapists, we get this question all the time. Which to use, heat or ice for an injury? The answer depends on the injury and how recent it is. Here are 6 simple rules to follow:
  1. Use Ice as first aid: immediately after an injury to reduce swelling and inflammation and bruising. (ie. Ankle sprain or any joint sprain). Use ice for 3 to 5 days following the injury. Moist cold will penetrate better than dry cold. Tip: soak a pillow case in cold water, ring it out and wrap the ice pack in it and apply.
  2. Use ice to reduce pain and swelling after recent surgery (ie. Joint replacement, ACL reconstruction, Rotator cuff surgery)
  3. Use ice if you need to move or put weight on the affected body part. Icing it first can often help to keep it functional until you’re able to get to a safe place to rest the affected area
  4. Use heat to manage persistent or intermittent pain and stiffness or older injuries
  5. Use heat to improve muscle elasticity and flexibility in elderly population (ie. Prior to stretching and exercise)
  6. Avoid heat on new inflammation (ie. Recent injury) because there is already heat there.
How long should I ice for? Generally, you want to ice between 10 to 15 minutes and then rest 40-60 minutes in between. This length of time will numb the nerve endings and provide pain relief.
How long should I use heat for? Heat can be used for up to 30 minutes.

The grey area

For neck pain or lower back pain experienced without injury or chronic arthritic conditions. In these cases, you can use either one. For people that suffer from ‘text neck’, tension headaches or migraines, putting ice on the back of the neck and base of the skull is indeed beneficial because it numbs the nerve and the pain. Heat or ice can be used for a sore lower back, depends on personal preference. Both modalities work on the pain-gating system of the brain meaning that a non-painful stimulus (like heat or cold) will block the painful stimulus from travelling to the central nervous system (the brain) and voila, pain relief!
Precautions with heat and ice

Make sure to check the skin to avoid burns and skin irritation with either modality. If you are laying down on the heat, ensure that you have enough layers protecting your skin.