Heat or ice: which is best for your pain or injury?

Sep 18 2020Anne

Heat or ice: which is best for your pain or injury?

From a soothing hot water bottle to a bag of frozen peas, many of us have turned to heat or ice at some point to help relieve pain, but do you know which therapy is best for your aches and injuries? Choosing the right one can be difficult, but choosing the wrong one can make things much worse! But don't worry, I'm here to help.

Cold and heat therapies are an easy, natural and inexpensive ways to help relieve pain, so it’s little wonder they are so popular.

They are generally very efficient at their job, and understanding which is the best one to use for particular pains and aches can help you ease soreness, stiffness, swelling and inflammation faster, as well as prevent them from getting worse.

This handy graphic highlights the benefit of heat and ice and which is best to use for your pain or injury:


Heat (also known as thermotherapy) allows blood vessels to dilate (open up), which stimulates blood circulation to help heal damaged tissues. Boosting blood flow to a painful area can also help to get rid of lactic acid waste build-up, which contributes to pain. The warmth also helps to relax sore muscles and ease muscle spasms and stiffness.

When to use heat:

Chronic problems

Apply heat to pains which have lasted for at least a week or for muscle and joint conditions that affect people’s lives for months or years, such as arthritis, fibromyalgia, sciatica or old injuries. Circulation in these conditions is often compromised because of scar tissue, compressed blood vessels or crushed nerves.

Back Pain

In a study which looked at the efficacy of thermotherapy (heat) and cryotherapy (ice) for pain relief for lower back pain, thermotherapy patients reported significantly less pain compared to cryotherapy.1

Another study found that continuous low-level heat wrap therapy was more effective than ibuprofen for treating low back pain.2

Muscle stiffness (without swelling)

Heat helps the muscles relax, improves circulation and reduces muscle spasms.

Joint pain and/or stiffness (without swelling)

Heat helps the tendons and ligaments improving flexibility, which helps ease joint pain and stiffness.

Injuries after the swelling has gone down

Heat relaxes the muscles in the area that may still be tense, improving flexibility.

Trapped nerves

Heat stimulates nerves and improves their blood supply.

Prior to physical activity

Applying heat before activity stimulates blood flow, warming up muscles and making tendons more flexible, which helps to reduce the risk of injury and ongoing problems.

How to apply heat

There are many different ways heat can be applied including hot water bottles, heating pads, heated gel packs, heat wraps, wheat bags, heat creams and rubs, a warm shower, sauna or a long soothing hot bath. Even a hot, wet towel can bring relief.

The heat should be warm, not excessive. Don’t apply heat for longer than 20 minutes and protect your skin from burns or scalds by wrapping a thin towel around any heat source. Also never use a heating cream along with a heating pad or wrap.

Rub the pain away

If you are feeling stiff and sore a warming muscle can give fast soothing relief. The warming effect of a rub or balm, together with the rubbing motion when apply can help ease sore muscles and aching joints.

You could try: Higher Nature MSM Joint and Muscle Warming Balm

The soothing balm has been specially formulated to help warm joints and muscles before and after exercise and activity. It also helps ease tired, stiff muscles, joints, tendons and ligaments. Naturally warming it contains n invigorating blend of MSM, capsicum, vitamin B3, aloe vera and essential oils of boswellia, ginger, black pepper, rosemary, eucalyptus, cornmint, peppermint and lemongrass.

Have a magnesium bath

Just soaking in warm water alone can help relax muscles and loosen stiff joints, but adding a magnesium soak to your bath can further relax your muscles. Magnesium plays an essential role in the healthy function of your muscles and joints and soaking it through your skin is considered to be the best way to obtain magnesium.

You could try: BetterYou Magnesium Flakes Foot and Body Soak

These magnesium bath flakes are a great way to top up your magnesium levels while you enjoy a nice relaxing bath! For a bath soak; dissolve 250g (roughly equivalent to two cups) in a warm bath and relax for 20 minutes.

When should heat not be used?

Don’t use heat on a new injury or bruising; it can make it worse by increasing bleeding under the skin around the injured area. Heat therapy is also not usually recommended for people who have diabetes or some vascular conditions.


Ice (also known as cold therapy or cryotheraphy) constricts the blood vessels, which slows down blood flow to injured or painful areas. This helps to reduce swelling, redness, inflammation and although often uncomfortable at first, it can also numb pain.

When to apply cold/ice:

New injuries

Ice is most commonly used to treat new injuries, within the first 48 hours. It helps to control the inflammatory response, which reduces swelling and pain, as well as bruising. Ice is ideal for injuries such as sprains and strains.

Pain due to over-exertion

The pain experienced in the 12-48 hrs following over-exertion is due to many very small injuries to the muscle fibres or to the tendons that attach the muscles to the bones. Blood rushing to the area causes inflammation, redness and tenderness, therefore cold is used to reduce blood circulation.

After a hard work out

Icing after a workout can help prevent muscle soreness. It also helps lessen the wear and tear of muscles and joints, allowing you to recover faster.

General inflammation or tenderness

The swelling that occurs with inflammation is also accompanied by pain. Cold helps numb sharp pain and reduce inflammation.


Ice can help calm gout flare-ups and numb pain.

How to apply ice:

For injuries such as knee or ankle sprains the R.I.C.E method is recommended – Rest, Ice, Compress and Elevate.  Rest it, put ice packs on it for 15-20 minutes several times a day, compress it with a wrap to help control swelling, then elevate it to help minimise swelling.

As a general rule never use ice for longer than 20 minutes at a time. Leaving ice on an injury for too long can reduce the blood flow to the injury and slow the healing process. If the problem gets worse or doesn’t show significant improvement in 48 hours, it is important to consult your doctor.

Also, don’t apply it directly to the skin. Use a cloth barrier to protect your skin from damage such as frostbite.

When should ice not be used?

Don’t apply ice to an open wound. It is also not advised to use ice if there is a risk of cramping. Ice can also make muscle tension and spasms worse.

Bottom line

A good rule of thumb is to consider the timing of the pain or injury. If it is new and there is pain, redness, inflammation and swelling then ice it.  If it is an older, chronic problem or minor sore muscles then use heat.