You’ve just rolled your ankle. It’s sore and you’re struggling to put weight on it. Should you put ice on it or heat? Most would correctly say ice.

But what about when you’ve woken up and your neck feels ‘locked’. Every time you try to turn it you get a sharp pain. Do you use ice or heat?

The Heat vs Ice issue is often one of great confusion. We have come up with a few tips to help make the choice clearer.


Ice is for injuries and heat is for muscles

This is a very generalised rule, but it is mostly accurate.

Ice is great for inflamed, red, swollen tissue because it is a mild and drug-free way of reducing the pain associated with the completely natural and necessary inflammatory process.

Heat on the other hand can help manage chronic pain, muscle pain and stress because it can relieve muscle spasm and can also help to calm the nervous system.


So what about injured muscles?

For true muscle injuries (i.e a muscle tear/strain), ice is best for the first 48-72 hours. Heat can be beneficial after the first couple of days and once the area no longer feels warm.


What about acute low back or neck pain?

In most back and neck injuries, even when the injured structure is a disc or joint, much of the pain is produced by muscle spasm. As a result, heat is often the preferred choice to reduce spasm and pain.


When NOT to use ice or heat

Heat can make inflammation worse, so putting a heat pack on a freshly injured knee or ankle has the potential to significantly increase swelling and pain.

By the same token, ice used on sore muscles (other than an acute muscle tear) can increase muscle spasm, trigger points and associated pain.

It is also best to avoid using heat when you’re already sweating or ice when you’re already shivering as it can overstimulate the nervous system. This can cause the brain to interpret the excess heat or cold as a threat, which can lead to more pain.


Listen to your body

At the end of the day, your body will tell you what it prefers. If using ice increases your pain, switch to heat, and vice versa. Both offer only mild benefits and will usually work more effectively when used in conjunction with other modalities.

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