Ice or heat? Which is best for aches and pain

By Dr. Matthew Simmons, Northside Hospital Cherokee Sports Medicine

Strains, sprains, headaches or wrenching back pain are sometimes facts of life.
But when something hurts, is it better to go for the ice or heat?

The easy way to remember is that you use ice for injuries and heat for muscles.

Ice, or cold therapy, can calm a damaged tissue or inflamed, hot red or swollen tissue. This is because ice constricts blood vessels and reduces swelling. Thus, ice is a natural, painkiller-free way to dull and numb the pain and decrease inflammation. Use ice when you have a freshly pulled muscle, ankle sprain, knee sprain or acute pain after intense exercise.

Apply ice or even a bag of frozen vegetables and be sure to apply ice soon after the injury. Limit icing sessions to 20 minutes because excessive icing will damage the skin or cause tissue damage.  To prevent frostbite, do not allow ice to sit against the skin without a layer of protection. Continue to ice the injury for 24-48 hours. You also want to elevate the injury and stay hydrated.

However, ice can make muscle tension and spasms worse. This is when you want to use heat.

Heat therapy is best to treat muscles, chronic pain and stress because of the ability to allow blood vessels to expand and muscles to relax. This includes back and neck pain or other pain of whole muscle spasms and trigger points. Apply heat therapy to arthritis, old/recurring injuries or stiff joints. Heat can be applied with a hot, wet towel or heating pad/pack. A hot bath or shower may also relieve pain.

However, keep in mind that heat therapy can make inflammation worse.

Dr. Matthew Simmons is a board-certified physician in sports medicine and family medicine, and serves as the director of the Northside Hospital Cherokee Sports Medicine Program, providing care to high school athletes throughout Cherokee County.  If you have experienced a sports injury, call 770-517-6636 to discuss how we can assist you with your specific condition and return you to peak performance.

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