For your Pain: Ice cold or Relaxing hot?

How do you like your morning tea served? Cold or Hot?  I am assuming hot right? But then, that’s not the question here. The question is the one we ask ourselves and others many a times  when in pain.

The war is out there Thermotherapy Versus Cryotherapy.

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Is Hot water fomentation/steam/Heating pad better ? vs Cold Water baths/Ice packs/ Air Spray coolants?

Before we get into the nitty gritty details, let me tell you something interesting. The use of heat dates back to earlier than 500 BC. Hippocrates often prescribed Hot water baths and steam for reducing muscle aches and spasms..

Thermotherapy Includes but is not limited to Hot water/Steam/Heating pads  (Moov, Iodex, Balms and any surface applicant causing warmth)

  • These work to increase the temperature of the skin. Increase in temperature, increases the blood supply to that area resulting in faster elimination of waste and pain producing products and increasing supply of nutrients to aid in the recovery process. Hence it helps to relieve pain instantly.
  • It also increases the elasticity of the muscles, by decreasing the resting muscle tension, freeing up stiff joints and muscles.

So like you’ll must have already guessed this works wonders for Muscles…

  • Chronically Stiff Joints due to degenerative arthritis- Knee, Shoulder or Back pain.
  • Muscle Spasms: Back catches, Neck Spasms or calf muscle pain.
  • Frozen Shoulder: Inability to move the shoulder completely till the end of range.

Before you get to heating your knee, shoulder or back, wait a Minute! There are a few precautions:

  • Never Use Heat for pain relief over a swollen area within 24-48 hours sometimes up to a week after injury. Trust me it will swell up like a balloon!!

Like we talked earlier it increases the blood supply to that area and helps in healing, then why not use it? When the body suffers an injury, it takes sometime to establish a proper environment to start healing. During that time gap, you might see some swelling and irritation in the area. Swelling means that the part is unable to effectively eliminate the waste. Increasing Blood supply to that area during this time will only increase swelling, clog the area more and hinder healing. This will also increase pain.

During such a time, Cryotherapy comes to our relief! (Ice packs, Relispray, Biofreeze to name a few)

  • Cold does something wonderful to the area it is applied. Right after an Injury, when the swelling starts to build up, decreasing the local temperature by icing, helps restrict the blood supply to that region (Vaso-constriction). Less Blood Supply less swelling.
  • Cold also works to numb the area down, decreases the irritation of nerves and decreases pain.
  • After sometime body’s mechanism causes increase in blood supply (Vaso-dilation) in response to restoring balance and a continuous cycle like this helps in effective elimination of waste and reduces the swelling.

Ice is a Savior when it comes to Acute Injuries, Acute on Chronic type of injuries and flare ups (inflammation)

  • It is widely used for sports injuries.(Contact injuries, Bruising, Internal hemorrhage)
  • Can be used over Fracture to minimize swelling and internal blood loss

There are a few precautions for this one too..

  • You might not want to use it over stiff joints. It increases the stiffness by constricting the blood supply and slowly the metabolism of that area.
  • Avoid in people who get easily hypothermic and don’t tolerate it well.

Did you know? In last decade or so, They figured out a way to save you from brain damage due to cardiac arrest by freezing you? Hypothermia- such is the power of ice.

Keep in mind the external temperature too. You don’t want to use ice when its freezing outside and heat when you are sweating a lot/ or its hot outside.

In-spite of these general guidelines, sometimes, things work in a little different manner in some people. At the end of the day, use what works for you the best…

Stay Pain free until next time!


Published by hemaliphysio

Ortho & Sports Physio, The Movement Analyst

3 thoughts on “For your Pain: Ice cold or Relaxing hot?

  1. Very useful information for everyone. ….and the way you have explained surely people with ailments, will now do it right as per the pain.


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