There is often confusion about whether to use ice or heat for pain relief. Ice is typically used to reduce swelling and block pain signals in the affected joints and muscles. Heat is more commonly used to increase circulation, reduce muscle spasm, and increase the ability of the tissues to stretch, thereby providing pain relief. Here are some guidelines to follow if you’re unsure which to use:

Use ice if:

• It’s within 48 hours of an acute injury
• You have visible swelling or redness at a joint
• You have tendinitis, bursitis, or arthritis (inflammatory conditions)

Use heat when:

• You have stiffness or tightness in your muscles or joint
• After the first 48 hours of an injury in the absence of visible swelling (heat, because it increases circulation to tissues, can increase swelling)
• Using ice would cause you to tighten up more (for example, ice on the neck for some individuals causes them to tense up, which counteracts the pain relieving effects)

Many times it’s a personal preference as well. I prefer ice for any injury and very rarely use heat. I especially like to use ice packs that fit into ace wrap or neoprene sleeves that Velcro around the involved joint to provide gentle compression and ice simultaneously. (These may also make it easier to ice frequently as you can be mobile with the ice pack fastened on.) On the other hand, I have colleagues who favor heat much more. If you’re unsure, I encourage you to experiment with both and see which gives you the most relief.