Should I Use Ice or Heat?

At our office, we often get the question, “Should I use ice or heat?” The answer really depends on the ailment. A brief overview of these two therapies is outlined below:


Ice should be used on an acute or recent injury; for example, spraining an ankle or being in an automobile accident. Ice packs are usually used for the first 24 to 48 hours after the injury. The cooling effect of ice raises the pain threshold and prevents further swelling. There are four stages one will experience when using an ice pack:

1.  It will feel cold.

2.  It will burn.

3.  It will ache.

4.  It will become numb.

Always wrap the ice pack in a towel prior to use to prevent a burn. Treatment time is approximately 20 minutes, 2-4 times a day. Ice can be reapplied as necessary, as long as there is at least one hour between applications to allow the temperature of the damaged tissue to return to normal.

Note:  Discontinue use if you begin to shiver. Never use dry ice.


Heat increases blood flow to and from the treated area, and it initially increases metabolism within the treated parts. This increase in metabolism speeds the tissue’s healing time. However, using heat too long, may lead to local congestion, edema, and reduced metabolism. Heat promotes sweating, which helps remove toxic waste. In addition, heat increases the skin’s pain threshold, which may, in turn, trigger enkephalin production (a natural pain reliever).

Heat should not be applied to a body part until 48 to 72 hours after an injury, perhaps longer if recurrent bleeding or swelling is a danger. Treatment time and intensity are determined by the doctor after examination of and consultation with the patient. At home, applications should last no longer than 20 minutes with at least one hour between applications. Heat should not be used until after the pain has subsided.

Note:  Localized heat is not recommended for patients with bleeding tendencies, extremely fair skin, rashes, sunburns, gangrene, over localized edema, or patients with a high fever.

Pearls of Wisdom

Always use ice for the first 48 to 72 hours after an injury, no matter what the condition. Some conditions necessitate using ice even longer than 72 hours. Sharp pain is usually the result of a sprain of a ligament or damage to an intervertebral disc. Both respond well to ice.

Never use heat unless the condition is chronic or unless you have been specifically told by a knowledgeable healthcare provider to do so. Dull pain is usually the result of a muscle strain. Strained muscles respond well to heat after the initial 48-72 hours of ice.

If you or someone you know is suffering from pain and have not found the relief for which you are looking, please call our office. We may be able to help.

Information provided by Christopher M. Renze, D.C., D.I.B.C.N., Renze Chiropractic Clinic, P.C.

For more information, visit or call the office at 965-3844. 

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