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Should you Ice or use Heat

Ice and heat packs are among the most common modalities used for short-term pain relief in the muscles or joints. However, heat and ice packs have different effects on your body and whether you should use heat or ice packs depends on the condition of your injury and most people often use the wrong treatment for their injury or pain.

In this article, we will break down the two treatments so that you will have a better understanding of how each treatment works and when you should one or another.

Long story short, you should use


  • ❄Acute Injury❄
  • ❄Pain❄
  • ❄Inflammation❄
  • ❄Swelling❄


  • 🔥Muscle Pain🔥
  • 🔥Stiffness🔥

Ice Pack (Cryotherapy)

How it works?

Ice pack or cryotherapy works by constricting the blood vessel, which then reduce the blood flow to the injured area. This will minimise the swelling and inflammation around the injured area as the white blood cells and other substances required for inflammation will enter the injured site in a smaller amount. Furthermore, research shown that ice can help temporarily reduce nerve activity, which helps to numb the pain and reduce any muscle spasms.

Types of Cryotherapy

There are a few form of cryotherapy that can be used for as injury in some people, which includes:

  • Ice packs
  • Frozen gel packs
  • Ice massage
  • Ice baths
  • Coolant spray

How to use an ice pack?

For acute injury (48-72 hours following injury), the most effective ice protocol to use is an intermittent 10-minute protocol. Just follow the 3 simple steps below:

  1. Apply ice on injured site for 10 minutes
  2. Remove ice for 10 minutes
  3. Reapply ice for 10 minutes

It has been shown that by doing this every 2 hours, we can achieve an enhanced analgesic effect and reduce the possibility of getting side effects such as nerve damage and burns

When NOT to use ice?

DO NOT use ice:

  • Chronic back and neck pain
  • Front or side of the neck
  • Left shoulder if you have a heart condition
  • Before or during training or competition
  • On a broken bone

ice packs and gel

Cryotherapy is best use on an injury that has just occurred to reduce pain, inflammation and swelling, however, you do not want to ice the injured region for too long as it has been shown that cryotherapy not only has no effect on the healing rate, but it can actually delays the recovery from eccentric exercise induced muscle damage.

It is recommended to apply cold cloth instead of ice packs on the neck area as applying ice pack there will reduce blood flow significantly to your head, which can be very dangerous as your brain needs constant flow of blood to function properly.

Another “side effect” or cryotherapy is the fact that it can severely inhibits your muscle power and functional performance, therefore it is recommended to apply ice protocol after completion of training or competition.

Be aware when applying ice onto a bone fracture site as it will cause significant pain due to large amount of nerve surrounding the area. Oftentimes the pain caused by applying the ice outweighed the benefits that the ice can provide, therefore, please be careful when applying ice on a potential broken bone.

Heat Treatment (Thermotherapy)

How it works

Heat works in an opposite way to ice where instead of reducing blood flow, it increases blood flow to the injured area. With an increase of blood flow, more nutrients and oxygenated blood are brought to the injured site, which increase the metabolic reaction rate, resulting in more rapid inflammatory and healing process. Furthermore, the increase in temperature of the blood also increase the dissociation of oxygen molecules from the haemoglobin, which makes more oxygen available for tissue repair. Thermotherapy also shown to have some positive effect on the pain threshold, making the injured area more tolerant to pain. Moreover, heat also increase the extensibility of tissues, which can then result in greater joint range of motion (ROM) and decreased joint stiffness.

heat packs

Types of Thermotherapy

Dry Heat – also known as conducted heat therapy and this includes sources such as dry heat packs, heating pads and even saunas. This type of thermotherapy is convenient and easy to apply.

Moist Heat – also known as convection heat and this includes courses such as steamed towel, moist heating packs or hot baths. This type of thermotherapy works slightly better than dry heat and require lesser application time too.

How to use a heat pack?

The recommended heating protocol include applying heat pack for 10 to 20 minutes at a time and make sure that the heating is not too hot ( >45oC) and applied less than an hour to avoid burns and cell protein denaturation. As heat pack only provide superficial heat, those deeper structures maybe need other deep heating agents such as clinical ultrasound or laser therapies in order for the heat to reach those structures.

When NOT to use heat?

  • Open wounds
  • Acute injury
  • A bruise or swollen area

As we mentioned above, when heat is applied on an injured area, there will be an increase in blood flow. Furthermore, it can worsen an open wound or bruise as the increase of blood flow can worsen the bleeding. Therefore, heat is recommended for chronic pain but not for acute inflammation.

Still not sure which treatment to use?

At Lakeside Chiropractic, our trained chiropractors can educate you as to which treatment will be best suited for your injury and if there is any need to modify the treatment protocol. We also provide clinical electrotherapy and laser therapy for deeper injury healing too.

Lakeside Chiropractic is located in Perth's northern suburb Joondalup and houses patients from all over Perth including, Victoria Park, Cockburn, Yanchep, Two Rocks, Jindalee, Wembley Downs, and Woodvale. HICAPS Facilities available on site for major private health insurers (NIB, HCF,HBF,AHM,HCI,HIF ) and also a part of the Medibank preferred practitioner and BUPA Members first network. If you would like to discuss any concerns, have any enquires or wish to book an appointment; feel free to contact one of our friendly staff on 9300 0095 or visit our website at

April 07, 2021