Heat vs. Cold Therapy: When to Use Ice and When to Use Heat for Back Pain
Arianna Aaron, DC • January 28, 2025
When you're dealing with muscle or joint pain, choosing the right treatment can make a big difference. Heat and cold therapy are two of the most common ways to manage pain, but it's important to know when to use each one. Here's a simple guide to help you understand when to use ice and when to use heat for your injuries or discomfort.
Cold Therapy (Ice)
Cold therapy is best used right after an injury or when you're experiencing swelling. It helps reduce inflammation, numb pain, and prevent further tissue damage. Here’s when ice can help:
- Acute Injuries: If you’ve recently twisted your ankle, pulled a muscle, or have swelling, apply ice within the first 24-48 hours. Ice helps reduce swelling and numbs pain.
- Headaches: Ice packs or cold gel wraps on your forehead or neck can provide relief from migraines.
- Arthritis Flares: Ice can help manage pain and inflammation during flare-ups, especially with conditions like gout.
- After Surgery:
For knee replacement or other surgeries, ice can reduce pain and swelling, helping you recover faster.
How to Use Ice:
- Apply an ice pack for 10-20 minutes at a time.
- Never apply ice directly to your skin—wrap it in a towel or cloth.
- If you experience numbness or discomfort, remove the ice.
When Not to Use Ice:
- If you have poor circulation, cold sensitivity, or certain health conditions (like Raynaud's disease), avoid ice therapy. Always check with your doctor before using ice if you're unsure.
Heat Therapy
Heat therapy works differently. It’s great for relaxing tight muscles and improving blood flow, which helps with chronic pain or stiffness. Here’s when to use heat:
- Chronic Pain or Muscle Stiffness: Heat helps ease ongoing pain from conditions like back pain, arthritis, or sore muscles.
- Before Exercise: Applying heat before a workout can increase flexibility and reduce the risk of strain.
- Post-Workout: For soreness that shows up a day or two after exercise (known as delayed onset muscle soreness or DOMS), heat can help relax tight muscles and reduce stiffness.
How to Use Heat:
- Apply a moist heating pad for 15-20 minutes.
- Be careful not to use heat for too long, as it can cause burns or discomfort.
- If you’re using a warm bath, make sure the water isn’t too hot and don’t forget the epsom salt!
When Not to Use Heat:
- Avoid heat if you have an acute injury (recent sprain or strain) as it can increase swelling.
- Don’t use heat if you have open wounds, infections, or certain health conditions like pregnancy, diabetes, or skin disorders.
In Summary:
- Use ice for swelling, fresh injuries, or inflammation.
- Use heat for chronic pain, stiffness, or after the initial swelling has gone down.
If you're unsure which therapy is best for your specific condition, don’t hesitate to reach out to our office. We’re here to help guide you toward the most effective treatment for your pain.
Stay healthy and take care of your body this holiday season!
At our chiropractic office, we focus on more than just pain relief and alignment. True performance and recovery start with how well your body and brain communicate. A new study reminds us that inflammation, often seen as a purely physical issue, also impacts your cognitive performance. A recent cross-sectional study, “Inflammation and cognitive performance in elite athletes” (Wiedenbrüg et al., 2024), explored how inflammatory markers, metabolic hormones, micronutrients, and recovery status relate to cognitive functions in 350 elite athletes. The findings highlight how systemic inflammation and nutritional status influence brain performance, directly affecting how athletes think, react, and recover. Key Takeaways Inflammation matters for cognition. Elevated pro-inflammatory cytokines (like TNF-α) were linked to poorer working memory and reduced cognitive flexibility, particularly in athletes from closed-skill sports. Vitamin D supports brain performance. Higher vitamin D levels correlated with improved cognitive flexibility. Hormones, stress, and recovery are interconnected. Processing speed and attention were best explained by a mix of metabolic hormones and physiological/psychological stress levels. What This Means for Chiropractic Patients Chiropractic care supports nervous system balance, which plays a key role in inflammation regulation and brain–body communication. This research highlights that cognitive performance isn’t just about “mental focus”, it’s influenced by your physiology. Chronic inflammation can dull your brain. Even low-grade inflammation affects how quickly your nervous system processes information. Recovery is brain training. Sleep, nutrition, and stress management enhance both musculoskeletal and cognitive recovery. Chiropractic care supports total performance. By optimizing nervous system function and joint mobility, chiropractic helps reduce physiological stress and improve neuromuscular communication. Actionable Tips for Athletes and Active Adults Prioritize sleep and active recovery to reduce systemic inflammation. Support your body with anti-inflammatory nutrients (omega-3s, vitamin D, and antioxidants). Include regular mobility and chiropractic care to keep your nervous system adaptable and responsive. Address stress holistically, mental, physical, and nutritional. In Summary The brain and body are one system. Your training, recovery, and inflammation levels shape how effectively that system functions. Chiropractic care fits into this picture by helping regulate the nervous system, support recovery, and optimize both movement and cognition. Reference: Wiedenbrüg, C., et al. (2024). Inflammation and cognitive performance in elite athletes: A cross-sectional study. Brain, Behavior & Immunity – Health, 36, 101431. https://doi.org/10.1016/j.bbih.2024.101431
NHIS data shows chiropractic outperforms other treatments for spine pain. Over 96% of patients say chiropractic helps with back pain and neck pain.
Chiropractic use in the U.S. is rising. Learn why more adults are choosing chiropractic care for back pain, neck pain, and headaches — and how Thrive Sports & Spine can help you.
NHIS data reveals why millions choose chiropractic care. Discover the most common conditions chiropractors treat — from back and neck pain to headaches and arthritis.
Facet joint pain causes up to 45% of low back pain cases. Learn the signs, treatment options, and how chiropractic care at Thrive Sports & Spine can help.
Most people experience ongoing symptoms after a head injury, but figuring out what’s really causing them can be tricky. Two conditions that often confuse patients and doctors are Post-Concussion Syndrome (PCS) and Functional Neurological Disorder (FND), including a type called Functional Cognitive Disorder (FCD). Both
Many people struggle with chronic lower back pain and want to know what’s really causing their discomfort. At Thrive Sports & Spine in South Jersey, our team uses advanced research-backed tests like the “Directional Preference” (DP) test to find out if your pain is coming from the discs in your spine – one of the most
Shoulder pain is a very common problem, often caused by rotator cuff injuries. Many people are looking for safe and effective ways to reduce pain and improve shoulder movement—one promising option is moving cupping therapy (MCT) combined with traditional physiotherapy.
Chronic lower back pain is a common problem, and one major cause is pain from the lumbar facet joints—small joints in the spine that support movement.
The original article 'Achilles Subtendons Stiffness Differ in People with and without Achilles Tendinopathy '
