The best option for pain relief: Heat vs. ice


The eternal question for someone in a bit of pain: “Should I use ice or heat?”

The answer is, it depends on the type of injury, how long you have had the pain and to some extent what feels better.

The general rules of thumb are:

  • Ice for acute pain or a new injury when there is swelling e.g. pulled muscle or ligament sprain
  • Ice for the first 3 days post-injury or until inflammation has died down
  • Ice reduces inflammation, commonly found in injured joints, tendons and muscles
  • Heat is usually more effective for chronic persistent pain
  • Heat relaxes sore, overworked muscles and muscle spasms

There are however, some exceptions…

Arthritis: Although arthritis is not an acute injury, many sufferers find ice soothes their symptoms. Others however, find heat helps. This probably depends to some extent on whether there is an inflammatory flare up.

Overuse or repetitive strain injuries like carpal tunnel syndrome, tennis elbow, iliotibial band syndrome, supraspinatus tendinitis, shin splints or plantar fasciitis. Many find ice eases pain associated with these conditions.

Lower back pain: the jury is out on this one also. Research shows similar effectiveness for both heat and ice. My advice would be stick to ice if you have a recent disc injury or sacroiliac joint problems. Otherwise go with what feels best!


Still not sure?

  • Always use ice over heat if there are any signs of inflammation or swelling. Heat can exacerbate inflammation, delay healing and increase your pain. Not sure how to tell if inflammation is present? Look for the physical signs of redness, pain, swelling and warmth, and be aware of when your pain worsens.
  • If you have a muscle strain or tear, use ice for the first three days, then switch to heat, particularly to warm up the muscle before attempting exercise.
  • Ligament sprains – use ice for the first three days or until inflammation subsides.
  • If you already feel cold, ice will probably tense you up further. Likewise if you already feel too hot, heat is likely to make you feel more uncomfortable.
  • Listen to your body. If ice makes you feel worse, then try heat and vice versa. Your body is very clever and has a natural tendency towards healing and health!
  • Why not both? There’s a method called contrast bathing, which is essentially using 5 minutes of ice, then 5 minutes of heat, rinse and repeat. This really helps to get the blood flow moving through, bringing the healing products to the area and taking waste products away.


If you have an acute injury or chronic pain, ice or heat alone will typically not be sufficient in getting you better.

It is always best to speak to a professional osteopath about the best treatment approach for your situation.

At Not Just Backs, we will do a thorough assessment and put together a treatment plan which will ensure a quicker recovery and reduce your risk of recurring pain or injury.

So call us today on 01722 512 521 or visit our new online booking page to see how we can help with joint pain, muscle or tendon injuries, arthritic pain and much, much more.

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