When to use ice and heat for pain relief

When you’ve just sprained your ankle or pulled a muscle, all you want is some pain relief. If painkillers are handy, you probably pop a couple of them. If not, you ask for some ice – or was that heat instead?

To sort out this confusion, let’s see what they really do. Both ice and heat relieve pain and help recovery.

How to use ice (cryotherapy)

Ice is useful when you want to reduce swelling. For example, your ankle balloons up after a sprain. This is because blood and fluid collects rapidly, making it both painful and stiff. 

At this point, an ice pack helps to close off those tiny vessels. The blood flow slows down. Small nerves become numbed, so the pain reduces. The muscles also relax. The inflammatory reaction is slowed down. As a result, your ankle is less swollen and painful.

Ice packs are very useful in bruises, strains and joint swellings. Use them for any acute swelling, over the first 24 to 48 hours (except back strains). Ice helps later too, while exercising the limb.

How to make an ice pack
Wrap a plastic bag of frozen peas or ice cubes in a thick cold wet towel. Place it on the injured part. Check after a few minutes to make sure the skin is not red, an early sign of frostbite. Generally, icing for 20 to 30 minutes is enough. Repeat every 2-4 hours.

RICE protocol: Rest, Ice, Compress, Elevate – and they apply it at the first sign of pain and swelling. Immediate action following an injury. 

The first and best thing to do when an injury occurs is to apply the RICE formula; a treatment for reducing pain and swelling.

Most people who sprain their ankle know of the RICE .

How to use heat
Heat packs, bottles or infra-red lamps can be very useful if you have a muscle spasm or 48 hours after injury. Icing a muscle spasm contracts the muscle fibers, so they would hurt intensely. On the other hand, heat improves the circulation, soothes and relaxes the muscles by carrying away toxins and bringing in healing oxygen. Heat can comfort a back or neck strain, especially if it has been persisting for some time. 

When you use a heat pack, wrap it in a towel and check the temperature so it doesn’t burn the skin.

When not to use heat

Don’t use heat if you have a painful, red or swollen joint. This increases circulation so that fluid collects, worsening the swelling and stretching or compressing the nerves and surrounding healthy tissue. This makes it still more painful. You’d be better off icing it.

When to use neither heat nor ice

Whether you use hot or cold packs, be aware that you can damage your skin and deeper tissues by careless use.

Don’t use it if you have an open or infected wound. If the circulation or sensation level is poor, as in diabetes, ice and heat could cause the skin to break down, get infected and worse.

But in ordinary injuries, ice and heat provide inexpensive, non-toxic pain relief.