Heat or Ice? The Best Ways You Should Handle 8 Common Pains

Updated: Feb. 10, 2017

Heating pads and ice packs come in handy for pain relief, but how do you know which is better? Is heat ideal for back pain? Will ice packs soothe pulled muscles? Here's how to figure out which treatment will work best for you.


Heat or ice: Back injury

If you’ve injured your back, a hot bath may sound like the ultimate cure-all. But according to Neel Anand, MD, clinical professor of surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles, California, that will only increase inflammation, making the pain worse. “Doctors recommend applying ice to the area for 20 minutes at a time during the first two or three days in order to decrease inflammation and pain.” These natural remedies for back pain may also help.


Heat or ice: Menstrual cramps

According to Yvonne Bohn, MD, ob-gyn at Providence Saint John’s Health Center in Santa Monica, California, there’s no definitive support for using heat on menstrual cramps, but she does recommend it. “For menstrual cramps, we typically recommend heat either from a bath or heating pad to the pelvic area for menstrual pain opposed to ice,” she says. “One study compared heat to placebo and showed improvement with heat over the placebo. The mechanism is not completely understood, but theories include relaxation of smooth muscle of the uterus and increasing uterine blood flow.” Here are other ways to relieve menstrual cramps.


Heat or ice: Joint pain

“As a general rule, I recommend heating a joint such as the knee or ankle before exercise, competition, or therapy. The primary objective of warming up is to prepare our tendons, ligaments, muscles, and joints for the explosive forces that are applied to these tissues during strenuous activity,” says Luga Podesta, MD, director of sports medicine at St. Charles Orthopedics in Port Jefferson, New York.


Heat or ice: Chronic back pain

Ice may be the ideal option over heat for back pain, but Dr. Anand says treatment differs when the pain is chronic. “People who suffer from chronic back pain without inflammation can find relief with a warm bath,” he says. Can’t figure out where that discomfort came from in the first place? These sneaky reasons might explain your back pain.


Heat or ice: Sprained ankle

When you sprain your ankle, bleeding and inflammation result, which requires ice, not heat, to limit swelling and constrict the blood vessels. Ken Jung, MD, foot and ankle surgeon at Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, explains: “Ankle sprains are acute injuries to the ligaments that provide support and stability to the ankle joint. This manifests as pain and swelling. Ice decreases swelling and inflammation while also providing pain relief by numbing the area.”


Heat or ice: Arthritis

Arthritis is a health problem which can be treated by alternating heat and ice. The heat promotes blood flow and relaxes the joints while ice can numb pain as well as reduce swelling. Alternating heat and ice requires some patience as you will need to figure out which combination works best for you. Consider using these other natural remedies to soothe arthritis pain.


Heat or ice: After-effects of working out

If you’ve just completed a strenuous workout and are in pain and wondering whether to use heat or ice, use ice on the affected areas to reduce inflammation. Do this right away and limit icing sessions to 20 minutes to avoid causing any irritation to your skin. Heat is not recommended for post-workout pain and muscle soreness as it can increase swelling and make the injury worse. When trying to remember whether to use ice or heat for pulled muscle injuries, keep in mind that heat expands while ice contracts. You want to avoid expanding inflamed muscles.


Heat or ice: Torn ligament

For ligament tears, Dr. Podesta recommends ice, not heat. “Typically I will recommend application of ice or submersion in an ice bath for 15 minutes every two to three hours for the first 24 to 36 hours after an injury. Icing helps to diminish blood flow to injured tissue, limiting swelling, inflammation, and pain. I do not recommend heat in the initial stages after an injury for fear of increasing the inflammatory response, swelling, and pain.”