Physical Therapy modalities, Ice or heat Should I Put Ice or Heat on My Injury And Why?

At BeneFIT we are commonly asked the difference between icing an injury or using heat. Is one better than the other? When should I use heat versus ice and vice versa?

The truth— both can be effective modes of pain relief if used correctly. First, let’s discuss the various effects of each treatment.

Cryotherapy is the application of ice for therapeutic benefits. Ice decreases the temperature of soft tissue and results in vasoconstriction, the narrowing of blood vessels. Cryotherapy works to provide pain relief, reduce tissue extensibility and reduce inflammation. It causes tissue metabolism to slow as well as neuronal responses which work to reduce the severity of tissue injury. Types of ice that can be applied include: reusable ice packs, ice baths or cooling gel/sprays.

 Thermotherapy is the application of heat for therapeutic benefits. Heat increases the temperature of soft tissue and results in vasodilation, the widening of blood vessels. Heat works to provide pain relief, improved tissue extensibility and increased oxygen for tissue repair. It is also important to note that heat encourages the break down of damaged tissue. Types of moist heat that can be applied include: hot packs, hot water bottles, moist heating pads, warm showers or warm baths.

Stages of Healing

However, which modality should you use and when? Well, that depends on the type of injury and stage of tissue repair. After trauma, the body initiates the healing process in three stages.

  1. The first phase is known as the inflammatory phase of healing. This phase is characterized by swelling, heat, redness and pain. The inflammatory phase begins a few hours after the injury occurs and lasts 1-3 days. Use ice during this phase! Do not use heat during this phase because it can worsen the inflammation.
  2. The second phase of healing is known as the proliferation phase. This phase is characterized by the production of repair tissue (i.e. scar tissue). It begins about 2 days after the initial injury occurs and can last for 2-3 weeks. Heat can now be applied to help speed up healing.
  3. The final phase of healing is known as the remodeling phase. This phase is characterized by maturation of the scar tissue that was developed during the proliferation phase. The main goal of this phase is the full restoration of tissue function. Heat is recommended during this phase to reduce stiffness.

The Final Thoughts?

Ice is best when applied to recent, superficial injuries. Heat is best for chronic, deep aches and pains. While certain phases of healing respond differently to ice and heat, both modalities are equally effective and safe pain relievers. Your own personal preference plays a major role in symptom response.

The bottom line is use what works best for you! If you start to use one and don’t like it, then try the other one!

Contact Us!

If you want to learn more reach out to us at 908.203.5200 for Bridgewater or 908.879.5700 for Chester. You can also reach us by DMing us on Instagram! Check out our recent blog to on insurance coverage if you have any addition questions!