Ice vs. Heat…What You Need To Know To Decide

One of the most common questions I get asked is… "should I be using ice or heat?"

To answer this question it would be prudent to start by explaining how each one works. You will then be able to make a decision as to which to use based on what you are trying to accomplish.

Heat causes the blood vessels to widen… or dilate. This is called vasodilation. This allows for more blood flow to the area.

Ice does the opposite. It causes the blood vessels to narrow… or constrict. This is called vasoconstriction. This limits the amount of blood flow to the area.

Let’s take a look at some common reasons people use either ice or heat, and figure out which one would be best.

Say you are walking down the street and you step on a tree branch causing you to sprain your ankle.

What is your concern? That the ankle will become swollen and inflamed.

In order to limit the amount of swelling and inflammation you would apply ice. This will cause the blood vessels to narrow (vasoconstriction) and the limit the amount of inflammatory chemicals that can come to the area.

Note: A good rule of thumb is to use ice for 72 hours after an injury…along with rest, compression and elevation. ( Always

remember – RICE after an injury…Rest, Ice, Compression, and Elevation. Anti-inflammatories (such as ibuprofen taken in the correct dosage) may also be appropriate but you should consult your physician before beginning anti-inflammatories as there are often side effects or interactions with medications you may already be taking.

Let’s say you wake up in the morning and you have a stiff neck.

What is going on? The muscles and joints are tight (or locked) from being kept in an awkward position for too long… causing your neck to feel stiff and painful.

In order to loosen up the muscles and joints you would want to apply heat. This will bring more blood flow to the area and allow the muscles to relax and the joints to loosen.

The question of whether to use ice or heat becomes a little more complicated when there are the multiple factors involved.

A typical example would be someone with arthritis. On the one hand the arthritis causes stiffness which can be relieved with heat. On the other hand arthritis causes inflammation which is relieved with ice.

Which one should you use?

It really depends on what your primary objective is in that situation.

For example, if you want to do exercise and your arthritic knee is bothering you, you may want to use heat before you exercise too loosen up the joint and allow it to move better. When you are finished exercising it would be a good idea to put on some ice to prevent inflammation that could be caused by all of the movement that you just did.

If you’re knee is inflamed, for example after spending a lot of time on your feet during the day, you would be best served by using ice. This will limit the swelling in the knee caused by the days activities.

All this is assuming that you can tolerate either one. However, in my experience many people do not tolerate ice well. If that is the case, use heat to loosen up the muscles or joints, or just for pain relief… but don’t use heat when you are already inflamed! That would be like adding fuel to the fire.

Note: How do you know if the joint is inflamed? Look at the area and feel it. If it is red or it feels warm…it is inflamed. Don’t use heat.

Some typical uses for heat are:

  • Sore or knotted muscles
  • Tight or stiff joints
  • General pain…without inflammation

Some typical uses for ice are:

  • Immediately after an injury
  • Joints or muscles that are sore from exercise or activity
  • General pain…If you tolerate ice

Obviously, you are ultimately the one who will decide which one to use. If you have been using one or the other for your aches and pains…and it is working, then great! Keep doing what is working.

If you weren’t sure which one to use, hopefully you will now be able to make an INFORMED decision.