Heat vs. Ice- Which is the better home remedy for aches, pains, and minor injury? | Total Performance Physical Therapy

Heat vs. Ice- Which is the better home remedy for aches, pains, and minor injury?

June 21, 2013

When someone’s back is sore or stiff they break out the heating pad to alleviate their pain.  When someone’s knees are achy, they break out an ice pack or cold peas to alleviate the pain.  Ice and heat are two very easy, accessible, and effective home remedies that people use for aches and pains everyday.  Heat and ice allow people to return to their everyday activities with less or no pain at all.  A common question amongst patients however is which one is the better option.  Yes, both remedies work for aches and pains, but one option may outweigh the other.

Heat & Ice- How They Work

Aside from the large temperature gap, there are profound differences as to how ice and heat affect the body.  Let’s start with heat.  Due to the rise in temperature, the metabolic rate and cellular activity increases.  This means that there is greater oxygen uptake of the tissues being heated which means more nutrients to the tissue and therefore results in increased healing.  The down side of heat is that one can gets burns if the heat is left on too long or the applied heat is too hot.  The temperature range for healing is 104-113 degrees Fahrenheit, once above this range the proteins of the tissue begin to fall apart and the damage is irreversible.

Another effect that heat has on the body is vasodilation, or the increase in circumference of blood vessels.  Vasodilation allows for increased blood flow.  For injuries to heal they need proper blood flow to the area for healing to occur otherwise healing will be delayed or not occur at all.  However, heat is sometimes unable to penetrate beneath the skin and the fat below the skin enough to get to the affected area of injury.  When this is the case the increased blood flow is not getting to the affected or targeted area.

Heat allows for decreased viscosity (resistance to flow of fluid) and muscle relaxation.  The combination of these two effects allows for an increased stretch of muscles, tendons, and ligaments therefore helping to alleviate stiffness.  Since heat causes muscles to relax, it helps with the pain many people deal with from muscle spasms that commonly occur after minor injury.

Now let’s get ice into the discussion.  Ice works in the same way as heat in that the energy and temperature are transferred through a method called conduction.  Conduction is the touching of the heat/ice against the skin and the reason why say your butt might be cold when sitting on the bleachers in the winter while watching a football game.  However, the physiologic effects of ice are the exact opposite of heat.  Ice causes decreased metabolic rate, vasoconstriction, and increased viscosity.  A similar effect that both heat and ice have is that they both decrease pain.

With ice, the vasoconstriction and decreased metabolic rate caused the injured or achy tissue to have decreased inflammation.  Inflammation results in pain, which is why ice causes decreased pain.  Ice also slows down the nerve signals that are sending pain messages back to the brain.  The biggest difference between heat and ice is that ice causes a decrease in secondary hypoxic injury while heat does not.

Since ice decreases the metabolic rate of the affected tissue is causes decreased secondary hypoxic injury.  Secondary hypoxic injury is like a ripple effect.  When any tissue is injured, the tissue surrounding the injured tissue is also ‘secondarily’ hurt.  Ice stops this ripple effect from happening and prevents the surrounding tissue from being damaged.  For this reason, ice is the better option than heat.  Both heat and ice decrease pain, but ice prevents further injury from happening.

This does NOT mean that you should not use heat.  Heat is good for loosening tight tissues, decreasing pain, and preparing someone for activity.  Heat is commonly used prior to activity while ice is used after activity.  However, if you only have time for either heat or ice, you should go with ice.

When icing a body part, apply the ice for 15-20 minutes.  Do not ice again for at least twice the amount of time that the ice was applied to the skin.  The reason is to prevent skin irritation.  Also when icing it should be noted that it is common to have these 4 sensations in the following order:

If while applying heat or ice you experience any discomfort, irritation, or pain (aside from the 4 normal sensations noted above with ice), you should remove the applied heat or ice.

If applying ice or heat does not work, call Total Performance Physical Therapy to schedule your appointment today!