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 Heat and ice can both be used to treat pain, and can be a very effective addition to any treatment plan. However, it can be terribly confusing to establish when to use either therapies. Here are few simple rules to help you determine when to use heat or ice – and which which types of injuries should be used for each.
Ice should be used for acute pain or a new injury that is causing swelling/inflammation. Ice is used to help reduce inflammation and to numb pain. Ice shouldn’t be used for chronic injuries – as it defeats the purpose of trying to bring blood and nutrients to the damaged tissue. Do not use ice for muscle tension and spasms, as it can make each of these worse. For an acute injury you should follow the acronym CBAN : use the ice through the stages of cold, burning, achy, and finally leave the ice there until the tissue is numb. This process usually takes 5-10 minutes. Do this every 30-60 minutes.
Heat should be used for chronic pain or an injury that is older than a day. It will help to relax the muscles and bring circulation to the tissue. Do not use heat on an acute injury as it can increase inflammation and even delay healing. Heat triggers vasodilation, which triggers blood flow, bringing oxygen and nutrients to the affected tissue. The increased blood flow also stimulates the elimination of metabolites and lactic acid flushing them from the sore muscles. In turn this relaxes muscles, reduces spasms, and releases tight tissue. Heat is also often used to reduce pain associated with osteoarthritis, long-term poor posture, latent trigger points, and to break down adhesions. Use heat as needed, for a minimum of 20 minutes.
A question I get a lot from clients is whether to use heat or ice on a freshly injured muscle. If there is severe pain associated with a muscle injury after a trauma I usually recommend a combination of the two therapies. Start with ice for the first few days, and then switch to heat to help relieve the tension in the tissues.
If you are SORE or tender after your massage treatment, we encourage you to apply ice wrapped in a tea towel to the sensitive tissue when you get home. This will help decrease inflammation and tenderness the following day.
If you feel STIFF after massage therapy, we encourage you to apply heat after treatment and/or the following day. This will help relieve your muscle tension!
Lastly, always monitor the area frequently to make sure the skin integrity remains intact and healthy. Be careful with smaller areas of the body such as the hands and feet – these areas be more sensitive to ice and heat therapy.
So next time you decide to tackle a new project, or if you suffer from old aches and pains, consider not only what type of injury it is, but also which therapy would be best to get the body back to functioning at its best!
Kristin Stewart, RMT

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