Should I use heat or cold? | Physioactif
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Should I use heat or ice?

Written by:
Philippe Paradis
Scientifically reviewed by:
Claudine Farah
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If you're in pain, you might wonder whether to apply ice or heat. This question comes up constantly, and for good reason, as the answers you find are often contradictory. You might have heard that you should always put ice on an injury, only to read elsewhere that it's actually bad. This confusion is completely normal.

Good news: The best approach depends on your situation, and both options are generally safe.¹ While neither hot nor cold has a miraculous effect on healing, they can help temporarily relieve pain. What science tells us about hot and cold:
  • Neither ice nor heat significantly speeds up healing; their main effect is on comfort
  • Heat is often preferred for muscle tension and stiffness
  • Ice can slow down healing if used excessively on an acute injury
  • Your personal preference matters, so trust what brings you relief

This guide will help you choose between hot and cold based on your specific situation. To understand how to manage acute injuries, please consult our article on PEACE and LOVE.

There is no single universal right answer

Several factors need to be considered. First, neither cold nor heat will have a miraculous effect on pain. From a scientific standpoint, there's no strong evidence that either is crucial for healing an injury.

Muscle Pain

For muscle pain, such as a stiff neck or muscle spasm, people often report that heat has a relaxing effect and can temporarily reduce pain. In these cases, a heat pack wrapped in a towel can be applied to the painful area for 15-20 minutes.

Acute pain

For more acute pain that has just occurred, like after an ankle sprain, people tend to think of ice for relief. However, current scientific findings suggest that ice might only have a small effect in such situations. negative on healing. Therefore, it might be best to avoid it. However, current studies on this topic are not strong enough to draw a clear conclusion. Nevertheless, there is no scientific evidence that ice is effective in aiding healing. So, for ice application it's best to use it only if pain prevents you from sleeping or if you are unable to control the pain with rest. If you do use it, crushed ice in a plastic bag is ideal. You should never apply an 'icepack' or 'cold pack' directly to the skin, as it can cause burns. An application of 15 to 30 minutes is sufficient.

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In short, here are three important conclusions to remember:

  • Neither heat nor ice plays an important role in healing an injury.
  • If you absolutely want to use one of the two, you can test between hot and cold to see what feels best and go with that.
  • In the case of an acute injury such as an ankle sprain, it is better to control the pain with rest than ice, but if you can't or you don't sleep well, ice can be a tool.

Sources

  • Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. British journal of sports medicine. 2017 Jan 1;51(2):113-25.
  • Vuurberg G, Hoorntje A, Wink LM, Van Der Doelen BF, Van Den Bekerom MP, Dekker R, Van Dijk CN, Krips R, Loogman MC, Ridderikhof ML, Smithuis FF. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British journal of sports medicine. 2018 Aug 1;52(15):956-
  • Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM. Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Frontiers in physiology. 2017 Mar 7;8:93
  • Duchesne E, Dufresne SS, Dumont NA. Impact of inflammation and anti-inflammatory modalities on skeletal muscle healing: from fundamental research to the clinic. Physical therapy. 2017 Aug 1;97(8):807-17.
  • Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.

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