Heat vs Cold: What’s Best for Injury Management?
When you’re dealing with pain or injury, one of the most common questions we hear is:
“Should I use ice or heat?”
The short answer is that it depends on the situation, and some of the traditional advice may no longer hold up.
The Truth About Ice
For years, ice has been the go-to for fresh injuries, with many people believing it helps reduce swelling, minimise damage, and ease pain. But research shows that while ice is helpful, it might not be doing quite what we thought.
Ice does not significantly reduce swelling. Instead, its main benefit is reducing pain by slowing down how quickly nerves send pain signals to the brain. This temporary numbing effect can be useful in the early stages of injury, especially if it helps you get moving again sooner – which in turn, may help reduce swelling over time.
To get the best effect, the skin needs to cool to about 10°C. The most effective method is crushed ice applied directly to the skin (as long as there are no contraindications, such as cold sensitivity or poor circulation). Pre-packed gel packs or frozen peas are convenient but often don’t get cold enough to achieve the same result.
If using ice:
- Apply for around 5-10 minutes
- Check the skin regularly for any reactions
- Avoid using thick towels or padding between the ice and skin
- Don’t apply for more than 20 minutes at a time
Where Heat Comes In
Heat is generally better suited for chronic pain or muscle tightness, not new injuries. It works by increasing blood flow and relaxing muscles, making it easier to move and stretch.
Use heat when:
- Muscles are stiff or tight
- You’re dealing with longer-term discomfort (e.g. neck tension or lower back pain)
- There’s no active swelling or recent trauma
A warm pack applied for 15–20 minutes can be enough to ease tightness and help you feel more mobile (especially before activity).
Not Sure What to Use? Use this Simple Guide:
- New injury, swelling, or bruising > Try ice (for short bursts)
- Muscle tightness, stiffness, or chronic aches > Use heat
- Unsure or pain not improving > Get it assessed
Everyone’s body responds differently and there are times when neither option is enough on its own. If you’re not sure what’s appropriate or the pain is lingering, a proper assessment can make all the difference.
Download the below graph as an easy to use reference guide:
HEAT vs COLD Quick Reference Guide
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