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Muscle Pain: Heat or Ice It?

An IU Health North Hospital Release An IU Health Saxony Hospital Release An Orthopedics/Sports Medicine Release

Carmel, Ind. ~ When an old injury flares up or you pull a muscle playing sports, minor injuries can be treated with cold or hot compresses. These less severe injuries that don’t require medical attention can be treated with temperature, but whether you choose ice or heat depends on what type of injury you are treating.

“Heat and ice are good first steps in providing pain relief before you can see a medical professional,” says Scott Cash, physical therapist and manager of Rehabilitation Services at Indiana University Health North Hospital. “Which temperature you use depends on the symptoms you’re experiencing.”

Ice Application
The application of ice to an injury, or “cryotherapy,” is typically used on a fresh injury. When you injure your body, your soft tissue becomes inflamed, causing swelling.

“With an acute injury, you’re going to use the ice right away to help with any swelling that’s occurred,” says Cash. “Ice is best for inflammatory conditions.”

When applying ice to a recent injury, it’s best to use the ice for 15 to 20 minutes at a time and repeat every couple hours. If you’re using a cold pack from the freezer, keep a thin layer of fabric between your skin and the ice pack.

“Ice constricts the blood vessels and helps decrease the swelling,” explains Cash. “Whereas heat is the opposite---it opens up a blood vessel even more. If you put heat on an inflammatory condition, you can cause more swelling.”

Heat Therapy
After the acute phase is over and you’ve had the injury for more than a few days, you can switch to using heat if it helps with pain symptoms. Heat is also useful for warming up muscles and stretching them out before a workout. Chronic, nagging injuries are best treated with heat because you want to increase blood flow to the area.

“Heat tends to loosen and relax the muscle so you can use heat for 15 to 20 minutes with more chronic pain conditions,” says Cash. “When applying heat, be careful that you have a layer of cloth between your skin and the heat because you don’t want to burn your skin. You’re better to lay the heat on top of you than to lay on the heat because your body weight is more likely to cause a burn.”

When to Chill or Warm
Only treat muscle pain at home if the injury is not severe. When you apply ice or heat remember:

  • Ice for fresh injuries: Use ice within three days of an injury occurring to numb the area and reduce swelling.
  • Heat for chronic injuries: Apply heat to injuries that are at least three days old or with chronic pain to warm up the area and help with pre-workout stretching.
  • Apply 15-20 minutes: Apply ice or heat for 15-20 minutes. Reduce the time if you’re applying ice directly to the skin. Prolonged exposure to ice can cause frostbite.
  • Do not sleep with a heating pad: You can easily burn your skin if you expose it to heat for prolonged periods of time.
  • Wrap packs in thin layer: Wrap the ice or heat source in a thin layer of fabric or apply against a layer of clothing so it does not directly touch your skin.

Have a twist, pull or strain? IU Health will take care of it. Walk in or call ahead for a Same-Day orthopedic care appointment at 317.944.9400. For more information on sports therapy, visit the IU Health North Physical Therapy & Rehabilitation page

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