Cold Therapy or Hot Therapy: Which One Works Best?

This issue of choosing between cold therapy and heat therapy had caused a great deal of confusion. This is unfortunate, as treating an injury with ice or heat is a cheap and efficient method to speed up healing and recovery. Although they are both beneficial, ice and heat treatment produce different outcomes during the process of recovery. This article gives you the general idea about these methods and their effectiveness.

Cold Therapy

Treating an injured area with a cold application is also called cryotherapy. It should be the first step after sustaining an acute injury. Ice therapy should be used for acute trauma, such as a muscle strain, a ligament sprain, a soft tissue contusion, and whenever swelling is present. Some other situations, where a cold compress is beneficial are minor burns, fever, and headaches. Whenever an acute injury occurred, the RICE (Rest, Ice, Compression, Elevation) protocol is the best first-aid treatment.

cold therapy ankle

How does ice reduce inflammation?

Cold therapy has two major effects on an injury. First of all, it blocks the pain by slowing down nerve conduction. Secondly, the blood vessels narrow due to cold, which reduces the local flow of blood and consecutively decreases swelling and inflammation. Another beneficial effect of cold therapy is a reduction of metabolism by lowering oxygen demand and therefore limiting further injury. As soon as the pain and swelling are gone, you can begin light exercise and start the natural healing process. So feel free to use ice for inflammation, however do not apply cold therapy for more than 20 minutes, as this may lead to frostbite.

How many days should you ice an injury?

During the acute period (first 3 days after an injury) it is recommended to always use ice to reduce swelling. For home treatment you can apply a towel-wrapped ice pack to the affected area. Make sure to avoid direct skin contact with a frozen item. Other options include ice baths and reusable cold packs. You should ice an injury as soon as possible.

Heat therapy benefits

Applying heat to a painful area of your body is called thermotherapy. It can help you the most if you have stiff muscles or a chronic injury without any swelling present. Unlike cold therapy, heat application intensifies local flow of blood, which in its turn brings more oxygen and nutrients to the area. Increased uptake of oxygen and nutrients speeds up the metabolic rate and is necessary to heal and regrow the injured structures. Tissue extensibility is also improved, as tight muscles and joints are warmed up and their stretching ability improves.

heat therapy

When tight, stiff muscles receive heat therapy, the stretching ability of tissue increases, joint stiffness and spasm pain decrease. This allows for an expedited recovery as the range of motion for the injured area increases. Do not exceed 20 minutes of heat therapy per application. Taking the stress of muscles and trigger points not only helps chronic pain, but also soothes the mind and the nervous system, as chronic stress and anxiety can by significant sources of chronic pain.

When should you apply heat to an injury?

It is not recommended to apply heat to an acute injury (1-3 days). After about a week, if you still feel the pain, you can try a hot compress to see how it works for you, however be very careful. You can chose either local or whole body treatment when applying heat therapy. For smaller areas, such as a stiff joint a hot water bottle or a heated gel pack or a steamed towel will work best. Take a hot bath or visit a sauna for a full body treatment.

Heat and Ice Combined

Alternating ice and heat therapy can be used in order to first constrict the blood vessels and decrease swelling, and then to speed up healing by warming up the area and increasing the circulation and metabolic rate. This contrast therapy protocol can be used after about 7 days, if the traditional RICE treatment was unsuccessful.

When Not to Use Ice and Heat

Heating up a fresh injury is a bad idea. If you apply a heat pad to a freshly sprained ankle, it’s going to swell up and become more painful. Ice therapy and stiff muscles are also a bad combination. Muscle spasms and trigger points can be easily mistaken for inflammation, and icing them will be a wrong call, as this will only cause more pain.  Trigger point therapy combined with heat therapy may be the best choice here.

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