Research suggests that there are several different protocols that can be effective in lowering inflammation and speeding up the recovery of an injury.
Ice or Heat? What to Use (and When) for Injuries and Pain Relief
You’re stiff. You’re sore. Maybe you rolled your ankle at the gym or tweaked your back doing something as harmless as reaching for your shoes. Now you’re wondering:
Should I use ice or heat?
It’s one of the most common questions we hear from clients with both new and long-standing pain. And the answer? It depends.
In this post, we’re going to cover:
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When to use ice (and why timing matters)
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When heat is the better choice
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How contrast therapy works (and when to try it)
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A simple, go-to recovery plan you can follow
When Should You Use Ice?
For fresh injuries — think sprains, strains, or bruises within the first 48 to 72 hours — ice is usually the best first step. It’s ideal for what we call the acute phase.
Why ice works:
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It shrinks blood vessels (vasoconstriction), which helps reduce swelling
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It numbs pain by slowing nerve signals
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It minimizes bruising and inflammation
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It may reduce muscle spasms after injury
You can use an ice pack, a frozen bag of peas, or even a cold compress. Wrap it in a towel and apply for 15–20 minutes every 2–3 hours during the first couple of days after the injury.
Just remember: don’t ice for too long or too often. Ice is best used short-term to control inflammation. After the first few days, your body needs circulation to heal — and that’s where heat comes in.
When to Switch to Heat
If the pain has lasted more than a few weeks, or if it feels like your muscles are just always tight, that’s when heat therapy can help.
Heat helps by:
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Widening blood vessels to bring in oxygen and nutrients
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Relaxing tight muscles and fascia
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Easing stiffness in joints
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Reducing tension and pain sensitivity
Heat is especially helpful for things like:
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Low back pain
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Neck and shoulder tightness
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Ongoing joint discomfort
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Muscle soreness post-workout
Use a heating pad, hot water bottle, or warm compress for 15–30 minutes at a time. A warm bath or shower can work wonders, too.
Can You Alternate Heat and Ice?
Yes — this is called contrast therapy, and it’s been used for decades in sports rehab and pain management.
Here’s what it can help with:
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Joint inflammation + stiffness
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Delayed-onset muscle soreness (DOMS)
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Post-exercise recovery for athletes
Here’s how to do it:
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Start with ice for 10–15 minutes
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Switch to heat for another 15–20 minutes
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Repeat for one or two cycles, and always end with what feels best
This method can improve circulation and decrease soreness — especially if you’re alternating between tightness and swelling.
Mistakes to Avoid
Even though cold and heat are simple tools, they’re often used the wrong way. Here are a few things to steer clear of:
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Icing too long or beyond the acute stage
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Using heat too early (especially if swelling is present)
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Sleeping with a heating pad (fire hazard + skin burns)
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Ignoring the pain if it’s getting worse, not better
When in doubt, reach out to a professional — especially if it’s a recurring injury or chronic pain that just won’t go away.
A Simple Plan to Get You Back on Track
Whether you’re training hard or just trying to move without pain, here’s your go-to approach:
Use ice within the first 72 hours of a new injury
Switch to heat for long-term tightness or pain
Try contrast therapy when pain and stiffness overlap
Don’t skip movement — light stretching and massage can speed healing
Ask for help if the pain is stubborn or you’re unsure what to do next
Final Takeaway: Listen to Your Body
Ice and heat are powerful tools when used the right way — but they’re not one-size-fits-all. The most effective recovery plans also include gentle movement, bodywork, and sometimes a little professional guidance.
If you’re not sure what’s going on — or you’re just tired of guessing — we’re here to help. Whether you’re dealing with an injury, chronic pain, or just feeling sore after a tough week, our team can help you find what works.
Sources
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Bleakley, C., Glasgow, P., & MacAuley, D. (2018). The Use of Ice in the Treatment of Acute Soft-Tissue Injury. The American Journal of Sports Medicine, 36(1), 212–219. https://doi.org/10.1177/0363546507306913
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Wilkerson, G., et al. (2020). Evidence-Based Guidelines for Cryotherapy in Injury Recovery. Journal of Athletic Training, 55(7), 675–682. Link
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Nadler, S.F., et al. (2020). Cryotherapy and Thermotherapy in Pain Management. Pain Physician Journal, 6(3), 295–299. Link
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Petrofsky, J.S., et al. (2019). The Use of Heat and Cold in Therapy for Muscle Pain. Journal of Applied Research, 19(2), 58–63. PMC6290837
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van den Bekerom, M. et al. (2020). RICE therapy for ankle sprains in adults: What's the evidence? British Journal of Sports Medicine, 54(2), 114–120. https://bjsm.bmj.com/content/early/2020/06/02/bjsports-2018-100096
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Clijsen, R., et al. (2022). The Effectiveness of Local Heat Applications. Archives of Physical Medicine and Rehabilitation, 103(4), 763–770. Link
