The application of heat and ice to ease pain has been an approach used throughout the ages, and when administered correctly can be an inexpensive, easy and safe way to treat injuries.

So, when should you apply heat and when should you apply ice? This may be the most commonly asked orthopaedic question physicians encounter. Using the wrong method of therapy could possibly increase your pain.

In this article, we provide guidelines and best practices for patients to understand the proper use of ice and heat therapy when dealing with aches and pains. If your bone, joint or muscle injury continues to cause prolonged pain, contact our orthopaedic doctors in RTP, Holly Springs, Cary and Raleigh to make an appointment.

Ice Therapy for Orthopaedic Injuries

Simply put, ice is for fresh injuries. Ice or cold therapy works by slowing down blood flow to the injured area, reducing inflammation and pain. Ice will also reduce the risk of tissue damage and swelling if used within 48 hours after suffering an injury. Furthermore, ice can act as a local anesthetic, numbing the area and slowing pain signals to the brain.

Some examples of new injuries and acute flare-ups that can be treated with ice therapy include:

  • Strains
  • Sprains
  • Tendinitis
  • Gout
  • Injuries and arthritis less than 6 weeks old

The best way to use ice therapy to combat pain is a cold compress or ice pack that is applied to the painful area for 20 minutes every 4 to 6 hours over a period of about 3 days. Never apply ice directly to the skin; always use a thin fabric or towel as a barrier.

Another popular way of using ice therapy is ice massage. Freeze water in a small paper cup, tear off the upper rim of the cup and hold the bottom in one hand. Rub or massage the exposed ice in a circular motion directly on the skin covering the injured area. To avoid ice burn on the skin, continue massaging the area, never holding the ice in one place. Ice massage can be administered 2 to 5 times a day with the sessions limited to 5 minutes at a time.

Another effective cold therapy method is a cold (not freezing) bath. A cold bath can ease all-over body aches from a vigorous workout.

The RICE method is a treatment our doctors recommend when patients have suffered a soft tissue injury (muscle, tendon or ligament). RICE is an acronym used for:

  • Rest: Rest the injured limb or area of the body
  • Ice: Apply one or more of the ice therapy methods described above
  • Compression: Wrap the injured area to help reduce swelling by limiting blood flow
  • Elevation: Further reduce swelling by keeping the injured area raised above the heart

Heat Therapy for Orthopaedic Injuries

Heat therapy is used for muscles and chronic pain. Heat therapy works by dilating the blood vessels, which increases blood flow. Increased blood flow will help tight muscles to relax and ease soreness. Better circulation will also help get rid of lactic acid buildup that occurs after some types of exercise. Heat can also have a mental effect, easing stress and creating a warm and cozy feeling in the brain.

Examples of injuries that can be treated with heat therapy included:

  • Osteoarthritis
  • Stiff and painful muscles
  • Pain and spasms in the neck and back
  • Sprains
  • Injuries and arthritis greater than 6 weeks old

There are both dry and moist heat packs available. Studies show moist heat packs act more quickly but can be used for less time. Other heat therapies include:

  • Heating pad
  • Hot water bottle
  • Hot compress
  • Hot bath (between 92 and 100 degrees Fahrenheit)

These heat therapies should be applied to the painful area for up to 20 minutes, 3 times a day.

When to See a Doctor

Both ice and heat therapies are safe and effective at-home pain and stiffness relievers. If pain persists, however, you should always consult a doctor. Cary Orthopaedics has multiple locations in the Triangle to treat your bone and joint injuries.