Direct Physical Therapy

Heat vs. Ice – What’s Better to Use for Your Pain?

A common question physical therapists are frequently asked is: “Should I use heat or ice to help relieve my pain?”   You may have asked yourself this common question.  Regardless of your age or activity level, it is very likely that you have felt pain or sustained an injury.  Below are some general tips and guidelines to help answer this question.


Ice is usually recommended to use on an area that has inflammation, which causes redness, warmth, swelling, and/or pain.  Ice is typically used as part of the initial treatment for sprains, strains and other acute injuries.

Ice treatments are generally recommended for 15-20 minute applications. It may be in the form of real ice or a reusable gel ice pack.  Ice is commonly used 3-4 times a day during the first 48 hours after a soft-tissue injury.

It is important to protect your skin from excessive cold.  Use a thin barrier such as a pillow case or thin towel to avoid direct contact with the ice/cold pack. Putting the ice pack directly on the skin, using it for long periods, or applying it too often could result in tissue damage – including frostbite.

Remember RICE:  Rest, Ice, Compression and Elevation.  When used in combination, these techniques will assist in reducing your pain and speeding your recovery.


Heat is generally recommended for chronic aches and pains, or new and minor muscular pains. People often choose a heat pack for problems like a stiff neck or a sore back. The muscles and joints seem to relax under the warming therapy. Heat can help improve circulation, increase movement and reduce muscle spasm. However, the application of heat could actually increase many acute inflammatory conditions.

Use heat therapy carefully. It is not usually recommended for people who have decreased sensation, diabetes or peripheral vascular disease. Warm is the goal temperature. Not too hot. Too much heat can harm skin and tissue – even cause blisters.

There are a number of ways to get heat to your sore spots. Heating pads and reusable gel packs provide dry heat. Other strategies like steamed towels, microwavable rice bags, whirlpools, or even showers/baths can provide moist heat.

These treatments are generally applied for 15-30 minutes. However, the benefits can remain long after the application has been removed.

For a longer lasting heat treatment, chronic back pain sufferers often choose heat wraps. These wraps can be worn underneath clothes and offer all day relief. The type of heat treatment relies on personal preference and/or professional recommendation.

Bottom line: Try ice for new injuries that cause pain, redness, and/or swelling. Choose heat for chronic pain or minor sore muscles.  When in doubt, get a professional opinion from your doctor or physical therapist.

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Direct Physical Therapy LLP

Direct Physical Therapy, LLP, was started by Scott L. Brown, PT, and Lance D. Cooper, PT in 2012. Our clinic is located in Ashland, Oregon and we provide quality, one on one treatment sessions.

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