Should I use heat or ice?

With every injury, we often wonder whether to use ice or heat to help with healing. Today, we clarify the answer to this question.

There is no one-size-fits-all answer.

Several factors need to be considered. First, whether it's cold or hot, neither option will have a miraculous effect on the pain. Scientifically, there is no evidence that either one is very important for healing our injury...

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Muscle Pain
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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. At this time, a heating pad wrapped in a towel can be applied for 15-20 minutes to the painful area.

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Acute pain

For more acute pain that has just occurred, such as after an ankle sprain, we tend to think more about ice for relief. Currently, science has concluded that ice in this case may have a small negative effect on healing. So, we should perhaps avoid it. However, the studies are still too fragile on this subject to have a clear conclusion. However, we have no scientific evidence that ice is effective in helping healing.

So, for ice, it is preferable to use it only if the pain prevents us from sleeping or if we are unable to control the pain with rest. If we use it, the ideal is crushed ice in a plastic bag. You should never apply an 'ice pack' or 'cold pack' directly to the skin, as you can burn yourself. An application of 15 to 30 minutes is adequate.

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.

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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.