It’s a question I get almost daily, whether I think a patient should ice or heat. The short answer is usually “whichever makes it feel better.”
Well, there you go… problem solved!
Not what you expected from a Doctor of Physical Therapy? Ok, let’s look at it a little more in-depth.
First, we should list what NOT to ice or heat.
Do NOT ice (without medical advice) if you have:
– open or infected wounds (in the area you are thinking of icing, anyway)
– impaired circulation (potential diagnoses: PAD, DVT, diabetes, varicose veins)
– impaired sensation (diabetes, neuropathy)
– Reynaud’s disease
– hypersensitivity to cold
– dermatitis or eczema
Do NOT heat (without medical advice) if you have:
– local cancer/tumor
– impaired circulation or sensation (see above)
– acute injuries (last 1-7 days)
– local infection
– current flareup of rheumatoid arthritis or other inflammatory condition
So, when DO you want to ice or heat?
ICE – Ice tends to be better for acute (recent) injuries. If it was recent, red, and/or swollen, ice is likely to be the better option. Inflammation is natural… it’s the first phase of the healing process. You don’t want to stop it completely, just dull the pain associated with it.
In fact, it’s very helpful to dull that pain so that you can MOVE. See, movement, encourages circulation, speeding up the healing process and helping to drive the swelling out. Between moving more and occasionally elevating the injured part, you will be well on your way to better healing.
HEAT – heat is usually better for longer-term pain/aches, stress, and muscle soreness. Again, the point of the heat isn’t necessarily something biological. It’s to make you more comfortable so you can move easier. The heat won’t penetrate nearly as deeply as the bloodflow from movement., and MOVEMENT IS USUALLY THE FIX FOR PAIN.
Regarding HOW to ice or heat, that will depend on the individual and their symptoms. You definitely don’t want to provide either to the skin or for more than 15-20 minutes, but you really should consult a healthcare professional (best option = your Physical Therapist) to tailor your treatment to YOU. Contact me if you live in or around Lee’s Summit or Kansas City for my input, if you’d like. I will even offer a completely free phone consult for you!
So, ultimately, if the goal of ice or heat is pain relief so you can move better, it really is all bout picking which one feels better for YOU.
To you feeling better,
Erik Pohlman, PT, DPT