Ice Versus Heat

By Dr. Deanna Minkler

Use caution when using either therapy. Ice and heat therapy both can interfere with circulation, especially in the elderly, immune-compromised, and those with circulatory problems or who suffer from serious disease. When in doubt, check with your physician. Never use any form of ice or heat therapy unless you’re certain it’s appropriate for you.

About Ice
Ice is used when an acute injury (e.g. sports injury, sprained joint, fall or other impact, whiplash, exacerbation of an existing injury, etc.) has resulted in acute inflammation in the area of injury. Signs of acute inflammation include swelling, redness or a change in skin temperature.

Ice helps to reduce swelling and inflammation, reduce redness and irritation, and reduce pain.

In general, ice is appropriate for acute stage care, however, if ice seems ineffective, or if you feel worse after 5 to 10 minutes, discontinue and consult your physician.

Using Ice Safely
Do not use ice if you have a cold allergy (hives, joint pain, nausea), Raynaud’s Phenomenon, decreased circulation, or desensitized areas.

When possible, use frozen gel packs for ice therapy. Gel packs reduce the risk of injury such as circulation problems or frostbite. Wrap the pack in a thin towel and apply it to the injured or painful area. Using a damp towel increases the ice’s effectiveness. If your gel pack is cloth-covered, you may apply it directly. Do not lie on the cold pack as this may cause some of the gel to escape the pack. You can expect to feel a little cold discomfort or aching in the area before any numbness or pain reduction takes place. Limit your gel pack sessions to 20 minutes each. It is recommended to use the ice intermittently, 20 minutes out of every hour; use the packs 20 minutes on, 40 minutes off, 20 minutes on, and so forth.

Ice Massage
Ice massage can also be used in acute injury. To do this, freeze water in a paper cup. When it is frozen, tear off ½ inch of the paper. Massage the injured area using a circular motion careful not to use heavy pressure. Continue for no longer than 5 minutes, or until the skin turns pink.

About Heat
Heat is used for chronic muscle spasm, chronic stiff joints, or chronic pain. Heat helps to increase circulation to the affected area, bring fresh nutrients to an area that is healing, and relax chronically stiff muscles and joints to improve function.

Using Heat Safely
Do not use heat if you have circulatory problems, hemmorhagic tendencies, sunburn, rash, or on desensitized areas.

Wrap hot pack in four to eight layers of thick toweling to start with. Adjust towel thickness as needed, but use caution. A pack that seems too cold at first may heat up rapidly.

In general, you may heat commercial hot packs in either boiling water or the microwave. Microwavable packs can be safer to handle in this regard, but you must warm them gradually. Follow the instructions that come with the pack (or from your physician).

A safe way to use heat is in the form of a simple compress heated in warm (not hot) water. Or soak in a warm bath, or let a warm shower run directly on the area. Regardless of the method you chose, limit heat therapy to 20 minutes.

As for heating pads, my advice is never to use them. Heating pads are dry heat and can overheat quickly and burn you before you know what’s happening. Also dry heat dries and congests the tissues, which increases the pressure on nerve endings and causes increased pain.

*Remember – before using either heat or ice therapy, consult your physician.

Ice and heat therapies are used for different
reasons. Consult your physician before
using either method in your home.

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