• MAY 14

    Heat vs Ice: Which One Is Better?


    Both applications can reduce the pain, but the question of when we need to use which application still remains. Therefore, patient preference and the effects of each modality should be taken into consideration when deciding which thermotherapy tool to use. There are clinical situations when either heat or cold may be selected to meet the needs of intervention objectives or when one is clearly preferred over the other. Cold is the preferred modality during the acute stages of inflammation; whereas heat at this stage may further aggravate inflammation.

    Heat: By increasing the temperature of the skin, the blood flow increases by process of vasodilation which will increase the metabolic rate and tissue extensibility. This increases oxygen uptake and accelerates tissue healing.

    Cold: By decreasing the temperature of the skin, blood flow decreases by process of vasoconstriction. This will decrease the metabolic rate which will aid in limiting further injury damage.

    When to Use Ice
    Ice is best used for acute injuries such as sprains and strains. Other injuries in which ice is used include tendinitis, plantar fasciitis, inflamed or swollen tissues, muscle spasms, and torn or pulled muscles.

    Acute Pain
    A symptom that results from injury and/or disease that causes or can cause tissue damage through infection, trauma, or a degenerative disease. Acute pain usually lasts less than 3 months and is usually well located and defined.

    Effects of Ice
    • Reduces blood flow by constricting blood vessels (vasoconstriction)
    • Decreases acute inflammation and bleeding immediately or soon after injury or surgery
    • Numbs pain by decreasing nerve conduction velocity
    • Lessens bruising
    • Decreases muscle spasms

    When to Use Heat
    Heat is best used for chronic injuries. Such injuries include stiff joints, tight muscles, muscle soreness, and chronic pain.

    Chronic Pain: Defined as persistent or recurrent pain existing for 3-6 months or pain that persists beyond the normal time expected for healing of injured tissue.

    Effects of Heat
    • Increases blood flow by dilating blood vessels (vasodilation)
    • Helps restore movement
    • Reduces pain
    • Promotes relaxation
    • Decreases tissue tightness and joint stiffness
    • Facilitate tissue healing
    • Decreases muscle spasms
    • Prepares stiff joints and tight muscles for exercise



    Application for Heat and Ice
    Do not apply heat or ice directly on the skin. Instead, wrap application with a towel to form a barrier. Do not lie directly on application. Doing so can burn or cause frostbite to the skin, as too much pressure can cause the application to become too hot or too cold. When applying ice, it is recommended to elevate extremity (above chest level) to further decrease swelling and inflammation.

    Duration of Applications
    Heat: Intervention time usually varies from 15-30 minutes. NO MORE THAN 30 MINUTES
    Ice: Intervention time usually varies from 10-20 minutes or once numbness occurs. NO MORE THAN 20 MINUTES

    Heat Application Precautions - DO NOT USE IF:
    • Over an area of poor sensation
    • Over areas of known malignancy
    • Over areas of acute inflammation
    • Over infected areas
    • Over areas of recent or potential hemorrhage

    Speak with your doctor or surgeon before applying heat. Make sure to check skin after application for any adverse reactions.

    Ice Application Precautions - DO NOT USE IF:
    • Hypertension
    • Thermoregulatory disorders
    • Over a superficial peripheral nerve
    • Over an open wound
    • Over an area of poor sensation
    • In the very old or very young
    • Persons with aversions to cold

    Speak with your doctor or surgeon before applying ice. Make sure to check skin after application for any adverse reactions.

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