Ice or Heat?

This question is often asked by patients who have a sudden onset of back pain or neck pain. They often say that they have received conflicting advice; one person tells them to use ice, and another heat. I would like to answer this question for you so that you will know which is appropriate for your needs.

Most pain of sudden onset involves inflammation. This is when your body sends certain chemicals to an injured area to initiate the healing process. These episodes can occur spontaneously, without any specific traumatic cause. Inflammation is necessary for healing to take place, but should be kept to a minimum, because inflammation causes increased tissue sensitivity, pain, and scar tissue formation. Ice should always be used to treat pain of sudden onset for 2-7 days, depending on the severity. This can be done as often as once per hour, for 30 minutes. The pack should be soft, like the commonly used gel packs, and a paper towel should be placed between your skin and the ice pack.

Heat is best for chronic issues like tight, stiff, sore muscles. I am referring to your everyday stiffness and soreness, not any type of acute flare up. The heat should always be moist. Many people will get a gel pack for use with heat and a few for use with cold. The best way to use the pack for heat is to warm it up in the microwave (it should be warm, not hot) and wrap it with a damp dish cloth. This will deliver therapeutic moist heat to your body and not dry heat, which damages tissues. Another option is to get into a hot bath with epsom salts which will not only loosen up tight muscles with moist heat, but replenish magnesium and sulfur. If you suffer with stiff achy muscles, try an epsom salt bath 3-4 times a week and you will quickly see the benefits.

The bottom line is, if your not sure, use ice. Putting heat on inflamed tissue is sure to make your pain worse.

Yours in Health and Wellness!

Dr. Douglas Hanner