As a Chiropractic Physician and Personal Trainer, I am constantly asked by my patients or clients, “Should I use heat or ice for this injury or condition?” This article will focus on the use of ice or heat applications for musculoskeletal conditions and will give you a better understanding of these natural forms of pain relief.

When someone pulls a muscle or strains a tendon from running, for example, the soft tissues in the area of pain become injured. Immediately after, the fibers of the affected muscle, tendon, and/or ligament become disrupted. The blood vessels that supply blood and oxygen to these muscles become broken, which leak varying amounts of blood and serum into the adjacent tissues. Soon after a soft tissue injury, localized swelling and inflammation occur. The injured tissues become painful and tender, both directly from the trauma and indirectly from the subsequent swelling. So, what is best applied after the injury? ICE!!! The swelling and much of the inflammation that follows an injury is largely due to the leakage of blood from the ruptured capillaries; therefore, cold applications with ice cause the blood vessels to constrict. This constriction of the blood vessels decreases inflammation and also provides pain relief. How might heat hurt an injury? Heating tissues causes the capillaries to widen. This widening can cause an increase in the leakage of blood from the capillaries and add to the swelling and pain, thereby prolonging the healing process. I always recommend for my patients to apply ice right after the injury for no longer than 20 minutes, take the ice off for 40 minutes, and repeat every hour for the 1st 48 hours.

When should someone use heat? Heat treatments should be used for chronic conditions (i.e. injuries which occurred over 48 hours prior) to help relax and loosen tissues and to stimulate blood flow to the area. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Do not use heat after activity or for acute injuries (injuries which occurred less than 48 hours prior). Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat, be very careful to use a moderate heat for a limited time (no more than 20 minutes) and use enough layers between your skin and the heating source to avoid burns. Never leave heating pads or towels on for extended periods of time, or while sleeping.

Another question often asked is what about pain from arthritis? I often recommend that my patients use ice to the affected joints in order to minimize inflammation and reduce pain, especially with a newly inflamed joint. However, ice usually causes stiffness to the local tissues; therefore, heat applications can sometimes work best early in the day by relaxing the muscles around the joints, while ice applications at the end of the day can minimize the inflammation resulting from daily activities.

Dr. Jerrilynn Primeaux is a licensed Doctor of Chiropractic and Certified Chiropractic Sports Physician at Advanced Chiropractic and Sports Rehabilitation Clinic within Snap Fitness in Lafayette, located at 2425 W. Congress Street. She is also a Certified Personal Trainer. She may be contacted at 337-456-7983 if you have further questions regarding this article.