Should I use heat or ice?

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.

The choice depends on your situation. Heat and cold can provide temporary relief, but their effects vary depending on the pain and the individual. ^{1, 2} A very sensitive area may not tolerate one or the other well. Stop any treatment that increases the pain. The precautions described below are still necessary, even if the sensation feels pleasant to you.

In 2010, Garra and his colleagues randomly assigned 60 adults with a recent muscle injury in the back or neck to two groups. All participants received ibuprofen, a medication for pain and inflammation. They then applied a hot or cold pack for 30 minutes. Pain decreased slightly in both groups, with no clear difference between them. Not all participants reported relief. The study does not allow us to distinguish the effect of the compresses from that of the medication. ³

• Relief from a compress does not prove that the injury heals faster.
• Heat can provide comfort or a sense of relaxation; its benefits depend on the situation.
• Results on ice vary depending on the injury and how it is applied. Observations in rats are not sufficient to predict healing in humans. ^{4, 5}
• Your preference can guide your choice only if the app follows safety precautions.

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.

Hot or cold: Is there a one-size-fits-all answer?

The choice between heat and cold depends on your type of pain, your tolerance, and the precautions you need to take. A compress can complement other methods of managing your pain at home. It is not a substitute for having a serious injury evaluated or for gradually resuming activities.

Gentle heat can help you feel comfortable or relaxed. Cold can also be used to provide temporary relief after certain injuries. If none of these options help, don’t push it. A reduction in pain alone does not mean the injury has healed.

The temperature measured at depth depends on the method of application. In a study of 21 uninjured students, a hot pack applied to the calf for 15 minutes increased muscle temperature by 3.8 °C at 1 cm and by 0.74 °C at 3 cm below the muscle surface. ⁶ These measurements relate to temperature, not to pain relief or healing time. They do not describe the effect of cold on a joint.

What should you use for muscle pain—heat or cold?

Heat can help relieve certain types of muscle pain. For lower back pain lasting less than three months, a review of nine studies found that certain heat applications provided some short-term relief. The results do not prove the same benefit for all types of muscle pain. ¹

Un torticolis ou une contraction musculaire douloureuse peut vous donner envie d’essayer la chaleur. Le but est le confort ou la détente. Utilisez une chaleur douce, avec une serviette entre la source et la peau. Pour une compresse ordinaire, limitez l’application à environ 20 minutes et retirez-la plus tôt si elle devient inconfortable. Ne vous endormez jamais avec la compresse. Attendez le retour de la peau à sa température habituelle avant de recommencer⁷.

Évitez la chaleur sur une entorse ou une déchirure musculaire qui vient de survenir, surtout si la région est enflée. La Muscle pain récente au bas du dos est une situation distincte où une chaleur douce peut soulager⁸.

Une étude de 2025 a comparé des bains froids, chauds ou à une température intermédiaire chez 34 hommes après des dommages musculaires provoqués en laboratoire. L’eau chaude a réduit la douleur mesurée en appuyant sur le muscle par rapport à l’eau à température intermédiaire. Aucune différence claire de récupération de force n’a été observée entre les groupes. Les bains prolongés et surveillés de cette étude diffèrent d’une compresse domestique; ils ne constituent pas un protocole à reproduire à la maison⁹.

Should you apply ice to an acute injury, such as a sprained ankle?

Ice can provide relief after an ankle sprain, but it is not a complete treatment on its own. Research does not guarantee that a cold compress will speed up the healing of an injury that causes acute—that is, recent—pain. Severe pain or pain that is getting worse requires evaluation, even if ice provides temporary relief. ^{2, 10}

After a sprained ankle, the concern that applying ice might slow down healing also warrants some qualification. In rats with a muscle contusion—that is, damage caused by a blow—ice modified certain inflammatory processes and left more muscle fibers still developing after 28 days. However, there was no clear difference in the surface area of the muscle fibers between the groups. ⁴ A contusion induced in rats does not allow us to conclude that an ice pack slows the healing of a sprain in a person. The effects on tissue repair depend on the specific context being studied. ⁵

The Collins review published in 2008 identified six human trials, four of which had significant limitations. Of the two highest-quality trials, one—which used a cooling gel—reported a benefit, while the other found no clear difference. Based on this body of evidence, it was not possible to draw a firm conclusion regarding improved recovery following a recent injury. ² Uncertain results do not mean that ice has no effect in all situations.

Pour appliquer le froid : enveloppez un sac de glace ou de légumes congelés dans une serviette humide. Ne l’appliquez jamais directement sur la peau. Pour une petite région osseuse comme la cheville, limitez l’application à 10 à 15 minutes; une grande région musculaire peut tolérer jusqu’à 20 minutes. Suivez aussi les instructions d’une compresse commerciale. Vérifiez la peau toutes les cinq minutes et retirez le sac plus tôt en cas de douleur, de coloration bleue, de plaques douloureuses ou d’engourdissement excessif. Attendez que la peau retrouve sa température habituelle avant de recommencer⁸.

Pour le chaud comme pour le froid : n’appliquez pas de compresse sur une plaie. La sensibilité et la circulation sanguine de la région doivent être normales. Si vous sentez moins bien le toucher ou si vous avez un problème de circulation, demandez conseil avant d’utiliser une compresse. Ne vous endormez pas pendant une application. Chez un enfant, demandez des conseils adaptés à son âge et assurez une surveillance adulte⁷.

The choice of a compress is based on three criteria:

• Relief from a compress does not guarantee that the injury will heal faster.
• Choose an option that helps you relax and suits your situation, while taking the necessary precautions.
• After a recent injury, first adjust any activities that worsen the pain. When you can resume movement depends on the injury and your tolerance; the compress is still a helpful supplement.

Pour une entorse de cheville, le guide de Vuurberg et ses collègues distingue la glace seule des soins qui combinent plusieurs interventions. Les preuves ne soutiennent pas la glace seule pour améliorer la douleur au repos, l’enflure ou la capacité à utiliser la cheville. Le guide rapporte toutefois moins d’enflure avec froid et exercices qu’avec chaleur et exercices dans une petite étude de 30 personnes. Il privilégie des exercices adaptés avec un soutien de cheville selon les besoins¹¹.

Dans un essai de 101 personnes avec une entorse légère ou modérée, l’ajout d’exercices dès la première semaine a amélioré la capacité à utiliser la cheville aux semaines 1 et 2. Les deux groupes recevaient des conseils de glace et de compression. Aucune différence claire n’a été observée pour la douleur ou l’enflure. Ce résultat soutient l’intérêt des exercices précoces adaptés dans ces soins; il n’isole pas un bénéfice de la glace¹².

When should you see a doctor instead of continuing with compresses?

Severe pain or pain that worsens after an injury warrants prompt evaluation. An inability to put weight on the limb or difficulty walking more than a few steps also warrants a visit to the doctor. Seek medical attention as soon as possible if there is significant swelling or bruising—or if it is getting worse—if the affected area is stiff or difficult to move, if home care does not improve the condition, or if a high fever, an unusual sensation of heat or cold, or chills develop after the injury.

Rendez-vous à l’urgence après une blessure si vous avez entendu un craquement, si la région est déformée, si elle présente un engourdissement ou des picotements, ou si la peau devient bleue, grise ou froide. Ces signes peuvent indiquer une blessure qui demande des examens. Ne poursuivez pas simplement les compresses en attendant¹³.

Sources

1. French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. Superficial heat or cold for low back pain. Cochrane Database Syst Rev. 2006;2006(1):CD004750.↩ Back to text: 1st, 2nd mentions
2. Collins NC. Is ice right? Does cryotherapy improve outcome for acute soft tissue injury? Emerg Med J. 2008;25(2):65-8.↩ Back to text: 1st, 2nd, 3rd mentions
3. Garra G, Singer AJ, Leno R, Taira BR, Gupta N, Mathaikutty B, et al. Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy. Acad Emerg Med. 2010;17(5):484-9.↩ Back to text
4. 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. Front Physiol. 2017;8:93.↩ Back to text: 1st, 2nd mentions
5. Duchesne E, Dufresne SS, Dumont NA. Impact of Inflammation and Anti-inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic. Phys Ther. 2017;97(8):807-817.↩ Back to text: 1st, 2nd mentions
6. Draper DO, Harris ST, Schulthies S, Durrant E, Knight KL, Ricard M. Hot-Pack and 1-MHz Ultrasound Treatments Have an Additive Effect on Muscle Temperature Increase. J Athl Train. 1998;33(1):21-4.↩ Back to text
7. Heat and ice. Sherwood Forest Hospitals NHS Foundation Trust (Royaume-Uni).↩ Back to text: 1st, 2nd mentions
8. Ice and heat treatment. Gloucestershire Hospitals NHS Foundation Trust (Royaume-Uni).↩ Back to text: 1st, 2nd mentions
9. Dablainville V, Mornas A, Normand-Gravier T, Al-Mulla M, Papakostas E, Olory B, et al. Muscle regeneration is improved by hot water immersion but unchanged by cold following a simulated musculoskeletal injury in humans. J Physiol. 2025;603(23):7603-7625.↩ Back to text
10. van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? J Athl Train. 2012;47(4):435-43.↩ Back to text
11. Vuurberg G, Hoorntje A, Wink LM, van der Doelen BFW, van den Bekerom MP, Dekker R, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52(15):956.↩ Back to text
12. Bleakley CM, O'Connor SR, Tully MA, Rocke LG, Macauley DC, Bradbury I, et al. Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial. BMJ. 2010;340:c1964.↩ Back to text
13. NHS. Sprains and strains. National Health Service (Royaume-Uni).↩ Back to text

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