Heat and cold therapy can often be helpful with managing your pain, but which one is best?

Pain is never fun. Muscle pain, joint pain and injuries are a part of life and they can sometimes prevent us from doing what we want to be doing. When you are in pain, anything that can provide some quick relief is worth knowing and both ice and heat can help to decrease pain.

When utilised correctly and at the right time, either heat or ice can be fantastic for pain relief. In most cases, ice works best with a new injury and heat for general aches and pains or long term injury.

Unfortunately, both can make your pain worse if used incorrectly.  That’s why it is so important to know which to use when and how best to apply them.


How does it help?

  • Reduced blood flow to an area
  • Acts to reduce inflammation/swelling in the affected area.
  • Numbs the affected area, acting as a form of local anaesthetic

When do I use ice?

  • Immediately following injury to reduce pain and swelling
  • Acute joint sprains, strains or tendinitis
  • Aggravations of chronic inflammatory conditions such as; gout, Osteoarthritis (OA), Rheumatoid arthritis (RA)

How do I use ice?

  • Apply ice for about 5-10 minutes
  • Then remove for 10 – 20 minutes
  • Stop icing the area when the area is numb and reapply once the area has warmed up
  • Ice should not be applied directly to the skin
  • Example of use: use ice pack on low back 10 min on/10min off/ 10 min on again on repeat as many times as you can but minimum 4 times/day

When should I NOT use ice?

  • NEVER before or during exercise
  • If the area is already numb/cold
  • Applying ice to a tight tender muscle may aggravate your pain
  • If icing leads to an increase in pain, burning or aching


How does it help?

  • Increased blood flow to an area
  • Improved movement
  • Relaxation of tight muscles

When do I use heat?

  • For general aches and pain
  • Muscle tightness, stiffness or tension
  • Before exercise
  • Long term injuries
  • To relieve pain and stiffness related to arthritis and degeneration

How do I use heat?

  • To heat one area eg: Heat rub before exercise
  • Hot water bottle/heat pack/heat rubs
  • Heat the area until warm (NOT HOT)
  • Around 10-20 minutes (or as long as comfortable)
  • To heat the whole body eg: Post exercise soreness
  • Warm showers/spas/saunas
  • Use for as long as comfortable. NEVER too hot

When should I NOT use heat?

  • NEVER on a new injury as it will lead to further inflammation and damage
  • When there are signs of active inflammation (sensitive skin, red/hot skin, swelling)
  • Immediately after exercise
  • In the presence of infection



Whether you are using heat or ice, it should help to decrease your pain, not make you feel worse. If you are feeling worse when you are using heat or ice or if you are unsure of which therapy to use OR your pain is worsening, do not hesitate to contact your Osteopath. We are here to help. If you have any further questions please feel free to email me directly: tom@pakenhamosteopathy.com.au