One of the most common questions we receive at the Buckingham Clinic is about using ice and heat. There is a lot of confusion surrounding when to use it, which one is better for reducing pain and how to actually use it.
So let’s try to clear up some of these common queries.
Both ice and heat have properties that promote a reduction in pain and tissue healing, and sometimes this is a personal preference as to which is more effective – probably why there is confusion surrounding the issue.
Whilst there is a degree of personal preference to which is better, the most important thing to note is that ice should always be used in acute injuries and heat avoided. Acute injuries are those which have occurred within the previous 72 hours. Why is this important? It is because there is bleeding within the tissues (bruising) initially, followed by a period of inflammation which normally last 3 days. Therefore, treatments such as heat and massage should be avoided in this time as it can cause further bleeding and inflammation, ice helps do the opposite. After this period, it’s still ok to continue using ice to help relieve pain, but you can begin using heat.
How should you use ice? Within the acute phase of injury and healing, ice is best used as regularly as every 2 hours and applied for 20 minutes. You should be careful not to apply directly to your skin as it can cause ice burn. Try wrapping it in a damp tea towel to create a barrier between the ice and your skin. Note that you don’t have to spend lots of money on ice packs or follow Andy Murray’s ice bath routine – crushed ice in a sandwich bag or even a cheap bag of frozen peas works just as well.
N.B. Those with cold sensitivity, circulatory issues, diabetes or infection should avoid using ice.
So when can you use heat? Heat can be used any time after the 72-hour inflammatory phase has passed. Heat is essentially a warm-up for your tissues. It helps make your muscles more pliable, reduces stiffness and ready for exercise. It also stimulates the delivery of oxygen and nutrient rich blood to the tissues which can reduce pain, muscle spasms and injury times.
Again, no need to rush out and buy expensive heat packs. A warm bath, shower or hot water bottle will suffice. Whilst you may find beneficial effects from heat in as little as 10 minutes, it can be used for as long as 2-3 hours, although the heated area should be checked regularly. Again use a towel as a barrier when applying heat locally or making sure the bath is warm, not hot