The Debate: Ice or Heat? (or Both?)

Both ice and heat can help your body heal -- depending on how and when they’re applied. When used properly, an altered temperature can be a great way to help speed up the healing process and reduce pain.

Many times, at Oak Point Health and Vitality Centre, we’ve noticed our patients’ use of ice or heat has made their symptoms worse. For example, it’s not uncommon to encounter a patient with low back pain who used ice, and found it intensified their pain. I say it’s time to clear up the confusion.

Our bodies have various receptors:

  • Mechanical receptors get stimulated by things like acupuncture, massage therapy, and exercise.
  • Chemical receptors get stimulated when we apply things like an herbal ligament or something like an arnica cream.
  • Thermal receptors get stimulated when we apply heat or ice on the skin.

Each of these are extremely important and each are addressed whenever a patient comes to Oak Point -- especially if that patient presents with pain. By stimulating all three kinds of receptors, we assist the body in blocking pain signals from going to the brain. This reduces your symptoms as well as helping to speed up the healing process of local injured tissues. 

But, when should we use ice and when should we use heat?

Ice: Use only during the acute phase of an injury (first 24-48 hours). For example, if you sprain your ankle, it will likely start swelling up immediately. This is precisely when we’d want to apply some ice on the injured ankle for 10-15 minutes at a time. Never leave the ice on for more than 20 minutes. 

Another time to use ice is when an area is swollen. Chronic issues such as old knee injuries, for example, can cause a joint to swell up. This might happen after playing a sport or being on your feet for a long period of time and is an ideal time to use the contrast bathing technique (alternating between ice and heat). Contrast bathing will cause the blood vessels in the area to dilate with heat and constrict with ice. When we alternate, we create a pumping action in the swollen area, assisting the body in flushing out any excess fluids and reducing the swelling. (Side note: you always want to end with ice during contrast bathing.)

Heat: Generally useful for chronic pain and overuse injuries, the application of heat onto a painful area can help increase circulation to the injured tissues as well as loosen up tight muscles. Twenty minutes at a time is ideal. Anything more than that may result in too much inflammation. 

Of course, all of the above are general guidelines and on rare occasions, some people with chronic injuries might feel better with ice. At Oak Point, we always recommend patients listen to their body. If something does not feel right, it probably isn’t. 

I hope this helped shed some light on the very common question and will help you make a better decision on what temperature to use when you’re in pain. For more info, feel free to contact us and schedule a complimentary consultation. 


Written by Dimitri Boules LAc, LMT, CPE, CPT