Therapy – Hot or Cold?

Therapy – Heat or Ice?


Is it better to put heat or ice?  That is a very common question I receive, and one I will cover today.  Wednesdays will be dedicated to therapy, and each week I’ll explore a different facet of the field.  Eventually, I’ll go into specific ailments, such as back pain, sprains, and how to care for them.

Here is a graph that explains how pain works:



First, as indicated by the nerve activity line, they’re always active.  But its only when we get past the pain threshold, that we do feel pain.

Now let’s see what happens when we put some heat:

As you can see, it does help decrease nerve activity, thus reducing pain symptoms.  On the flip side, it also lowers the pain threshold, therefore, that can help explain why after you remove the heat the pain comes back so quickly.  This is a feeling often experienced after a hot shower.

Now what if we put ice:

In this instance, not only does it reduce nerve activity, but it also increases the pain threshold, thus reducing chances pain coming back.

In light of this information, heat and ice both have their uses.  Heat should be used if the goal is to increase circulation, for example if the affected area feels very cold, and for simple muscle relaxation.  Cold on the other hand, should always be used in the first 24-48 hrs of an injury, it helps to control swelling.  Cold causes the constriction of small blood vessels, prevented swelling to take place.

This is an interesting topic, and I’ll get into more details next week about more precise applications for each treatment methods, and how best to apply it on one self.