You’ve rolled your ankle. Your back is aching after gardening. Your shoulders feel stiff after a long day.
Do you reach for the ice pack or the heat pack?
It’s one of those simple health questions that can produce surprisingly conflicting advice.
For most everyday aches and minor injuries, it helps to start with a different question: What are trying to achieve?
The focus is often on what symptom you want to treat first.
Heat and cold can both be useful for short-term symptom relief, but they’re not treatments that determine whether your body will heal properly.
When might ice be useful?
Cold can temporarily reduce pain and is commonly used after recent soft-tissue injuries such as sprains.
For example, if you’ve just rolled your ankle and it is painful and swollen, an ice pack may make it more comfortable.
Australian Healthdirect guidance recommends ice as part of early self-care for sprains and strains. For an ankle sprain, it recommends applying an ice pack for short periods during the first couple of days, with a barrier between the ice and your skin.
The important point is that ice is primarily being used to help manage symptoms such as pain and swelling.
You don’t need to make the area extremely cold, and ice should never be placed directly against bare skin.
When might heat feel better?
Heat is often more appealing when the problem isn’t a fresh injury.
Think of an aching lower back after a long drive, shoulders that feel stiff after working at a computer, or muscles that are sore after a day spent doing jobs around the house.
A warm shower, wheat bag or heat pack may feel soothing and can make an area feel more comfortable to move.
Heat is generally not recommended immediately after a new sprain or strain where there is swelling. Healthdirect advises avoiding heat during the early stage of these injuries.
As with ice, more isn’t better. Heat should feel comfortably warm rather than hot enough to burn the skin.
Helpful to know
Neither heat nor ice is compulsory
If you’ve always been told that every injury must be iced, or every tight muscle needs heat, it’s useful to know that these are mainly tools for managing symptoms.
If one makes you more comfortable and it is appropriate and safe for your situation, that’s useful.
If neither helps, you don’t have to keep using them simply because you think you’re supposed to.
What about movement?
This is the part that’s easy to overlook while debating heat versus ice.
Imagine you’ve mildly sprained your ankle.
Ice may make it less painful, but the ice itself isn’t the whole recovery plan. Healthdirect advises that people with an ankle sprain can begin gentle exercises, walking and weight-bearing as they are able, depending on the injury.
Or perhaps you’ve spent several hours in the garden and your back feels stiff later that evening. A heat pack might be comfortable while you’re sitting down, but getting up periodically and moving may also feel better than remaining in the same position for the rest of the night.
The goal isn’t necessarily to eliminate every sensation before you move.
For many uncomplicated musculoskeletal problems, comfortable movement and a gradual return to normal activity are part of recovery.
A few precautions matter
Heat and cold aren’t appropriate for everyone.
Take particular care if you have reduced skin sensation, impaired circulation or a health condition that affects your ability to judge temperature. If you’re unsure whether heat or cold is safe for you, check with your doctor or another appropriate health professional.
For a new injury, seek medical assessment if there is significant swelling or deformity, you can’t comfortably use or put weight through the injured area, pain is severe or worsening, or you are concerned you may have a fracture or more serious injury.
And if an ache or pain isn’t behaving as expected, keeps returning or is limiting what you can do, it may be worth having it assessed rather than repeatedly alternating between the freezer and the heat pack.
So, heat or ice?
There isn’t one answer for every situation.
For a recent minor sprain or strain with pain and swelling, cold may be useful during the early stage.
For an older ache or feeling of muscular stiffness, warmth may feel more comfortable.
For both, think of heat and ice as ways of managing how you feel rather than as the entire treatment.
And once you’ve put the pack away, consider the next question:
What can I comfortably start doing again?
At Feel Amazing Wellness Centre in Chatswood, our practitioners provide individual assessment and care for a range of musculoskeletal concerns. Treatment and advice will depend on your symptoms, health history and individual circumstances.
References
Healthdirect Australia – Sprains and strains.
Healthdirect — Sprains and strains
Healthdirect Australia – Sprained ankle.