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When to Use Heat Versus Ice for Pain

By Christina Battisti | Updated on January 09, 2022

Medically reviewed by Srinivas R. Nalamachu, MD

Every pain is different. Each type can be a symptom of an underlying issue, an unpleasant sidekick to a condition, or an overall nuisance on everyday life. Treating pain can vary as well. While going straight to the doctor or trying an over-the-counter medication are options, another can be applying hot or cold compresses to the area where the pain is happening.

Hot vs Cold for Pain: What’s the Difference?

While both temperatures can soothe pain, they do so in different ways. Heat increases blood flow, nutrients, and oxygen to the affected area and, therefore, works to relax tight muscles. Cold lessens pain by reducing inflammation, muscle spasms, and circulation. While reducing circulation sounds bad, it’s actually a good thing because less circulation means your blood vessels shrink, which then lessens swelling and bleeding.

Let’s explore the different kinds of pain and how each respond when heat or cold is introduced:

Joint Pain/Inflammatory Pain

Typically caused by conditions such as arthritis and some autoimmune diseases like rheumatoid arthritis, joint pain/inflammatory pain can feel like stiffness in the joints or an “on fire” feeling throughout the bodyor similar to how you feel when you have the flu (fatigue, exhaustion, chills, etc.). Triggers for this type of pain can include intense physical activity, stress, and even weather. When to use heat or cold to treat joint pain depends on the cause of the pain and what works best for you. For example, gout responds well to heat because it eases stiffness and relaxes the muscles in the surrounding area. Osteoarthritis, on the other hand, does well with cold because it numbs pain. Once you know the underlying cause of your joint pain, such as an arthritis condition, you can talk to your doctor about adding heat or ice to your treatment plan and/or to manage flare-ups.

Heat may be better for pain caused by inflammatory conditions such as arthritis to ease stiffness and relax the muscles. (Source: 123RF)

Muscle Pain

Muscle pain can affect one or more sections of the body at a time and can be caused by injury or overuse. For instance, with back pain, you could be hurting because you overworked your back muscles at the gym or because you strained (or “pulled”) a muscle by tearing the fibers of skeletal muscle. For the most part, if muscle pain is temporary (or acute) it can be treated with cold compresses for no more than 15 minutes a few times a day and rest to allow tissues to heal. At the same time, if the pain is chronic (lasts longer than 6 months) heat is the best bet; it can even be alternated with cold if desired.

Icepacks or cold compresses may help alleviate nerve or muscle pain. (Source: 123RF)

Nerve Pain

Nerve pain can be caused by many different types of conditions and varies in how it feels. For example, a patient with sciatica (a condition where pain is caused by spinal nerve compression in the lower back) can be described as a “radiating” pain; other times, nerve pain can feel like numbness or tingling. Pain caused by conditions such as sciatica respond well to ice or cold treatments because that temperature tends to calm inflammation and numb any soreness in the tissue. It’s best to use cold when the pain is still sharp and move on to heat once that sharpness has subsided. The heat will increase blood flow and help tissues heal faster.

Home remedies like heating pads, microwavable gel packs, a ziplock filled with ice, or a store-bought freezer pack and other compresses can be helpful in alleviating frequent chronic pain. Apply for no more than 15 minutes at a time, two to four times a day. At the same time, it’s important to know your body’s limits. Regardless of the type of pain you are experiencing, if you get to a point where the pain is intolerable or if it turns into numbness or weakness, see your doctor right away.

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