Ice or Heat?

When to use hot or cold therapy

Treating Pain with Heat and Cold

Firstly, it is important to know whether a specific injury requires ice or heat. Generally speaking, ice is required for fresh injuries where tissues become swollen and inflamed, whilst heat is for long-term chronic pain including lower back pain, stiff joints and aching muscles. If used incorrectly, heat can make inflammation significantly worse, and ice can aggravate symptoms of tightness and stiffness, worsening pain in the process.

Always consult a medical professional if you are unsure if your injury requires heat or ice. You should only perform hot or cold therapy for the medically advised time of 20 minutes per application, every 2 hours.

  • Cold therapy
  • Heat therapy

When you tear a muscle or sprain joints – soft tissue damage occurs, blood vessels rupture and the injury site begins to swell. Applying cold therapy to treat injuries yields the following benefits:

  • A decrease in fluid buildup and swelling at the site of injury by constricting blood vessels and slowing down the metabolism of the cells.
  • Nerve endings at the site of the injury are numbed which decreases their ability to send impulses perceived as pain to the brain.
  • It slows the release of chemicals that cause pain and inflammation.

Heat therapy is the application of heat to the body for pain relief. Heat is generally used for more long-term injuries that have no inflammation or swelling. Sore muscles and stiff joints are well suited to heat therapy. For sportspersons, heat can be applied before exercise, to increase elasticity. However, heat should NOT be used post-workout – ice is the preferred option in this situation.

Compression may also be combined with heating to warm an injured area much more quickly than heat therapy on its won. Due to increased contact with skin and increased tissue density, tissues will reach their optimal heated temperature quicker, and will maintain it for longer periods after the treatment ends. Heat therapy helps relieve pain and stiffness, and with the added component of compression, its benefits are fully optimised and achieved more quickly.

Note: Don’t heat the injured area for longer than 20-minute intervals, or whilst sleeping.


The R.I.C.E technique involves all the components that are needed to prevent further injury to the damaged site immediately after the injury has been sustained.

If applied correctly and in time the R.I.C.E technique can greatly reduce the recovery time.

The R.I.C.E technique is the gold standard treatment of acute sporting injuries. The most important time in the treatment of acute sporting injuries is the first 24-48 hours.



Rest from any activity that increases your pain. It is also important to avoid activity that causes an increase in pain or ache even after rest following the activity (such as the next night or morning). Ideally lie down in a comfortable position to minimise bleeding, swelling and further damage. Rest may also involve the use of crutches, a protective brace, supportive taping or the use of a sling, etc.



Ice the injured area for 20 minutes every 2 hours. Use an ice pack wrapped in fabric. (N.B. People who are sensitive to cold or have circulatory problems should proceed with caution when implementing ice treatment).



Compress the injured area with an elasticated sleeve/wrap to help minimise swelling. If after applying the wrap/sleeve you experience pins and needles, numbness or any colour change in your extremities (e.g. foot or hand), the sleeve is too tight and is most likely restricting the circulation. It must, therefore, be loosened or even completely removed. You should also take off your elasticated sleeve before sleeping.



Elevate the injured area above the level of your heart (provided this does not cause an increase in pain) for as long as possible to minimise bleeding and swelling. Elevation can be achieved by lying down with foot on a cushion, or similar.