Ice or Heat – How to Decide 

 July 20, 2012

By  Dr. Tripp Stover, D.C.

Mechanicsville Virginia Chiropractor – Most everyone has experienced an injury of some sort that requires extra care in order to relieve pain, reduce inflammation and speed healing. Usually either ice or heat is recommended to help achieve these goals, even if you don’t need chiropractic care at that time.  But how do you know which to choose? Both heat and cold can be beneficial in certain circumstances, but each can also cause more harm than good if applied at the wrong time. Following are a few guidelines to help you decide on the best course of treatment.

The first general rule is to ice an acute injury or a flare up of a chronic problem and apply heat to a chronic injury. Swelling and inflammation is your body’s natural first response to injury – your blood vessels expand in order to rush more blood to the area to begin the healing process. So the best thing to do within the first 24 hours of an acute injury is to apply ice. This will allow the blood vessels to contract, reducing inflammation and bringing down the swelling, in addition to acting as a pain reliever by helping to calm irritated nerves.

Ice or cold packs should never be applied directly to the skin, as this may cause frostbite. They can be wrapped in a damp washcloth or towel, or even simpler is to use a bag of frozen peas. Ice should be applied to the injury for about 20 minutes every two hours within the first 72 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours, unless it is used to aid recovery after a strenuous athletic workout or if an injury is slow to heal due to regular re-aggravation, due to lifestyle challenges (like a job duty that can not be avoided).

Heat treatment is most useful for chronic injury (the classis “bum knee from high school sports injury”), as it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. For example, sitting in a hot tub may feel good, however, the following day you will likely feel more pain and stiffness due to the increased inflammation it has caused. Heat can also reduce joint stiffness and muscle spasms.

Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. This is a BIG if!  When in doubt about this fact, defer to ice.  Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm rather than hot treatments should be used to avoid the risk of burns, and heat should never be applied for an extended period of time or while you are sleeping. Heat treatment is also useful in cases of chronic injury, such as overuse injuries in athletes, shoulder impingement syndrome, bursitis and tendonitis.

Ultimately, if you are seeking some pain control, and you can’t remember the details of this post…use ICE.  You really can’t go wrong.  It will not hurt you.  If you use heat inappropriately it will compromise healing some, but it does NOT help with the pain.  Sadly, heat at the wrong time usually causes more pain in the long run (despite how good it feels during application).  I hope this is helpful.  Call us if you have any questions – 804-559-1100

Stover Chiropractic, P.C.

Real. Simple. Healthcare.



We are located at 9097 Atlee Station Road in Mechanicsville, Virginia, 23111.  This is a Hanover county address, but we are minutes from Glenn Allen, Innsbrook, Sandston, and Varina.  We also serve many people from King William and New Kent Counties.  Our close proximity to I295 means we are very easy to reach from most places in the Richmond Metro area.

Dr. Tripp Stover, D.C.

Dr. Stover grew up in Richmond. He has been married to his wife Andrea since 2000 and they make their home in Mechanicsville with their children, Avery and Garnett.

Dr. Tripp Stover, D.C.

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