Too Heat or Not To Heat?

Too heat or not to heat? Football-injury-300x200 (1)

Some questions answered on the dilemma on whether to apply heat or cold to an injury.


This is a question that I come across a lot here at The Physio Clinic so I thought that researching and writing down a few guidelines might help in the dilemma, hot or not?


Heat and Cold are the two most common pain-relief therapies for muscle and joint pain. They both are advantageous in that they are easy to apply and are inexpensive.

Which one you use depends on whether the pain is a new one (acute) or one that keeps re-occurring.

In general a new or acute injury will result in inflammation and possibly swelling (just think of a freshly sprained ankle!). Application of ice in the form of an ice pack/bag of peas wrapped in a clean damp cloth will cause vasoconstriction or narrowing of the blood vessels and so decreasing blood flow to the area which reduces pain, muscle spasm and inflammation. Applying ice will not stop the inflammatory process as this is necessary to kick start the healing process but it can help to temporarily ease pain.

It is recommended that ice be applied every few hours for 24-48 hours after the injury. Ice should not be applied for more than 20 minutes and skin should be checked every 10 minutes to check for ice burns. As physio’s we always recommend that ice should be used in combination with rest, compression and elevation after an acute injury.

Heat in general is used on more ongoing aches and pains including those niggly cases of low back or neck pain. Heat does the opposite of cold in that it causes vasodilation or opening up of blood vessels. This in turn increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments and tendons. The warmth can also decrease muscle spasm and thereby increase joint range of motion. Again application time should be limited to a maximum of 20 minutes and skin should be checked every 10 minutes to prevent burning. In applying heat only a warm hot water bottle or heat pack wrapped in a clean cloth should be applied to prevent risk of burning.

With both hot and cold it is important not to apply either to open wounds, infected or broken skin. Areas of diminished sensation occurring with poor circulation or diabetes should also be avoided.

If you are in any doubt- seek professional advice.

Antonia Hook

Antonia Hook