Which Is Better for Pain: Heat or Ice? 

After experiencing an injury or during a flare-up of a condition that causes chronic pain, many people have the same question: Should I use ice or heat to treat pain and inflammation? The answer often depends on timing and what is causing the symptoms, although sometimes it comes down to individual preference. 

Cold Therapy for Injuries

For muscle pain and injuries that cause acute pain, such as a sprained ankle or fracture, cold therapy is usually the best treatment to reduce inflammation. Most effective the first 48 hours after an injury, applying ice or a cold pack to the affected area has a numbing effect and reduces swelling by constricting blood flow. 

To apply cold to an injured area, place or hold an ice pack, a reusable gel pack or crushed ice in a plastic bag on the painful area for 20 minutes, a minimum of two to three times per day. Be sure to wrap the pack in a moist towel to avoid frostbite and wait at least 20–40 minutes between applications. 

However, you should not use cold therapy if: 

• You have poor circulation. 
• Open wounds are present. 
• You have a condition that makes you very sensitive to cold. 
• The area is numb. 

Heat Therapy for Chronic Pain and Stiffness

If you experience pain and stiffness from arthritis, back pain or other chronic issues, heat can help ease your discomfort. While cold decreases circulation, heat therapy works by increasing blood flow and relaxing muscles, making it a good choice for muscle spasms and stiffness. Because heat can make inflammation worse after an injury, use it for chronic pain issues. Applying heat can be a good way to warm up your muscles before a workout as well.  

To get the benefits of heat, try using a heating pad. Moist heat tends to work faster, as it penetrates into muscles more deeply. You can create your own hot pack by moistening a towel and heating it in the microwave for 20–60 seconds. Remember to test the pack on the inside of your arm to make sure it is comfortably warm and not too hot.  

However, keep in mind that heat can actually worsen your symptoms in certain situations. Because heat promotes blood flow and widens the capillaries, it can increase swelling and discomfort after physical activity. It’s also best to avoid heat when: 

• You have an elevated temperature from heat stress or fever due to illness. 
• Open wounds are present. 
• You have an acute injury, such as from playing sports or falling.  

But keep in mind for chronic pain, such as a bothersome back or sore neck, many doctors recommend using whichever method works best for you. If you need advice about whether to use heat or ice, you can schedule a telehealth visit with your doctor, or use the CHRISTUS Health online provider tool.

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