When to use ice vs heat

Do You Know When to Use Ice and Heat Therapy?

Ice packs and heat pads are among the most commonly used treatments in orthopedics. Using ice and heat for therapy is an easy way to care for your injury or manage your pain at home. However, there’s a lot of confusion as to when to use ice vs. heat for injuries and pain. 

So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last? 

Inflammation, pressure, and swelling are some of the reasons why pain can be so hard to manage when it comes to an injury. Ice helps reduce inflammation and numb pain, whereas heat helps relax muscles and stiff joints. While heat helps improve circulation and blood flow, ice reduces blood flow thereby reducing inflammation and swelling. 

Ice Treatment

Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48 hours) where swelling is a problem, you should be using an ice treatment. Ice packs can help minimize swelling around the injury, reduce bleeding into the tissues, and reduce muscle spasms and pain. 

Ice packs are often used after injuries such as an ankle sprain. Applying an ice pack early and often for the first 48 hours will help minimize swelling. Doing so will help to control the pain. 

Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Avoid icing a chronic injury before activity. 

You can make ice packs with ice cubes in a plastic bag or wrap them in a towel; a pack of frozen peas is also ideal and can go in and out of the freezer. When applying ice directly onto an injury, keep the pack moving to avoid ice burns. Remove the pack immediately if the injury appears bright pink or red. As a general rule of thumb, you should only use ice for 15 to 20 minutes at a time. 

Heat Treatment

Heat treatments should be used for chronic conditions to help relax tight muscles and relieve aching joints. This is especially helpful to improve range of motion on a joint that maybe isn’t moving as well. For inflammation of joints caused by arthritis, using moist heat, like a soak in a tub or shower helps. 

Do not use heat treatments after activity, nor after an acute injury. Just remember, “Warm up, cool down.” – Apply warm heat before an activity and ice after an activity.  

Do not use heat where swelling is involved—swelling is caused by bleeding in the tissue and heat just causes more blood to come to the area. 

Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping. Heat therapy can be used for a longer period of time than ice but is often effective within 15 to 20 minutes. 


The inflammation of joints or pain caused by arthritis can cause pain and stiffness in places like your elbows, knees, shoulders and fingers. For these instances, using moist heat, like a soak in a tub or shower helps. 

Muscle Strains and Sprains 

Muscle strains and sprains usually benefit from a combo of both ice and heat when they occur. Whether you’ve pulled a muscle in your back doing yardwork or sprained your ankle playing basketball, it’s best to start off with ice to ease inflammation (including swelling, redness or tenderness of the injury). Only after the inflammation resolves is it a good idea to switch to heat; this can help relieve any muscle stiffness at the injury site.


Tendonitis, a painful inflammation issue caused by repetitive activities, affects the tendons, the connective tissues between your muscles and bones. To alleviate the pain, rest, over-the-counter pain relievers and ice are recommended. Ice is preferred to ease the inflammation and help numb the pain.  

Florida Orthopaedic Associates is dedicated to keeping you active and pain free – getting you back to what matters most. If you are dealing with an old or current injury and it is not responding to home treatments, make an appointment today.