Young woman with shoulder pain

Hot vs. Cold: When Should You Use Each to Treat Pain

Should you ice that painful joint or put the heating pad on it? It’s a common question that comes up. Chances are you’ve tried both and gotten a certain amount of relief from each, but they offer different mechanical actions. The truth is either one will off a degree of initial comfort, but there are basic rules that help you decide what form of temperature therapy is right for each type of pain.

When to Use Cold Therapy

Cold treatment reduces inflammation or swelling. If you keep that in mind, then you get a sense of when ice is the best option for your pain. Inflammation occurs after an action, so if you just worked out and your back aches a bit – that is due to inflammation. The connective tissue and joint are swelling from the trauma of your workout.
Ice is also the standard initial treatment for an injury. When you twist your ankle, it swells up. Ice reduces that inflammation to aid in healing.

When to Use Hot Therapy

Heat, on the other hand, tends to loosen things up. Late at night after a long day on your feet, your back and hips might ache – this is when applying heat offers you the best chance of relief. When you feel stiff and sore, you want to consider sitting down with a heating pad and letting that warmth improve your circulation and enhance your range of motion.

Alternating Cold and Heat Treatments

Of course, there are times when you might alternative cold and heat to get pain relief. Let’s go back to that sprained ankle. Ice is part of the initial first aid you apply to a traumatic injury. Once the cold reduces the inflammation, you apply heat to enhance the circulation and aid in healing.

How about that sore back? Just after you exercise, the elements in your lower back will swell. This is a direct result of damage done during your workout. Unfortunately, that damage is a necessary part of strengthening muscle tissue. The trauma that comes from exercise forces the body to tear down that muscle and build it stronger to prevent further injury. Apply cold right away to that injury to reduce the inflammation. Later on in the day, you may feel stiff and achy. That is also a result of your workout, but it is not from inflammation.  You need to apply heat to promote healing of the damaged muscle.

Ultimately, it boils down to “acute” vs. “chronic” pain. You just finished physical therapy and your injured shoulder is swelling from the exercise. You just fell on your wrist or twisted your ankle. These are all acute injuries that benefit from ice. Chronic means it happens all the time. Your back always aches right before bed or your knees always hurt before it rains. Treat this pain with heat.