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How should I use ice and heat to treat pain?

Lori Smatt, DC
Chiropractic Medicine
To treat pain, you should only use ice in the first 48 hours after injury; then a combination of heat and ice in the following days. In this video, chiropractor Lori Smatt, DC, explains the proper way to use ice and heat for pain after an injury. 
Steven Shoshany, DC
Chiropractic Medicine
If you have an acute injury, ice should be applied within the first 72 hours, and heat thereafter. In this video, chiropractor Steven Shoshany, DC, explains why a majority of practitioners who deal with pain and injury suggest this routine.
Dr. Darria Long Gillespie, MD
Emergency Medicine
Both ice and heat are modalities that we use to treat muscle or joint pain. But there are different scenarios in which you should use each, and it’s important to use them correctly.
  • ICE: After any acute injury -- if it is newly painful, swollen, bruised, or just recently injured -- icing is a good way to reduce inflammation and swelling. Ice constricts blood vessels, which will help to numb pain, reduce swelling and bruising, as well as alleviate inflammation.
  • HEAT: Think of heat as something to use for a more chronic problem, like arthritis, tight muscles, stiffness or muscle spasms. It will not help with inflammation, but can do the opposite. It will increase blood flow, which in turn will relax tight muscles and ligaments. Steer clear of heat for acute injuries, as it can worsen inflammation and delay healing. 

Ice packs can help reduce swelling and numb painful joints and muscles, but some folks prefer moist heat to ease aches. Others find the best relief from a combination of both. Follow these basic guidelines: Use ice -- never heat -- in the first 48 hours after an injury, and make sure never to place an ice pack directly on the skin (use a paper towel or cotton lining). After the first 48 hours, use heat or alternate heat with cold. Not sure which is best? Check with your doctor.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.