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Ice Versus Heat

Woman applying ice to her knee
Patients frequently ask us about when they should choose ice and when they should choose heat. In a nutshell, we tell them that 99% of the time if you choose ice you are correct. Read on for a thorough explanation.

When you have pain there is always inflammation. Inflammatory cells travel with the blood. When you use ice, it deters the blood from that area of your body, also kicking out the inflammation. It allows the area to settle down, calm down and begin to heal.

“But ice doesn’t feel like it’s doing anything” is a common claim patients make. Actually, it IS doing something…on a cellular level for the greater good of the healing process.

“But I don’t like ice” is another popular comment. Do you want to feel better? Good, so just listen and use ice and you’ll heal faster.

“But heat feels good” is another thing we hear. Heat attracts more blood flow to the area and therefore draws more inflammatory cells. The more inflammation, the longer it takes to heal. So ask yourself, do you want to take a longer or shorter time to heal? If you answered shorter, then throw your electric heating pad in the garbage and use simply ice.

Can I ever use heat?

Moist heat is typically used to start off a physical therapy session in an effort to warm up the tissues so they can get right to work. Additionally, some fibromyalgia patients fare better with heat. So unless you are in a physical therapy session or have fibromyalgia, then we do not recommend you use ice.

Where do I apply the ice?

Since everyone is different, the best answer we can give you is to ask Dr. Tagliarini. The answer is most often going to be to apply the ice across the neck or back. This holds true even when symptoms radiate down the arms or legs or up to the head. The nerves begin at the spine, so you should ice along the spine (where the inflammation typically starts) even when symptoms travel.

How long do I apply ice?

The “magic number” with ice is 15 minutes. Setting a timer on your phone, smart watch or microwave is a good tip. When you apply ice, your body goes through 4 phases…cold, aching, burning and numbness. It takes 12 minutes to get to the numbness phase, which is when the ice starts to have a therapeutic effect. So if you ice less than 12 minutes, you won’t get the desired effect. On the flip side, ice will have a reverse effect after 20 minutes and start to attract inflammation back to the area. Since the therapeutic window is 12-20 minutes, we recommend 15 minutes as the target time. Icing two areas? If you have two ice packs, you can ice them at the same time to save time.

Other ice tips…

A gel ice pack is preferable because it conforms to you. Therefore it is more comfortable than a bag of ice cubes or a hard ice block you would use in a cooler. We always have gel ice packs in stock at the office for only $10 if you need one. Always put something between your skin and the ice such as a layer of clothing or thin dish towel. You can ice up to once per hour but not more than that. Bring zip lock bags with you if you are traveling since you can get ice pretty much anywhere.

In conclusion…ice ice baby!

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