Ice vs Heat for Pain Relief

When you’ve just sprained your ankle or pulled a muscle, all you want is some pain relief. You might take a couple of painkillers if they’re handy. If not, you reach for some ice; or was that heat instead?

Both ice and heat can relieve pain and help recovery. To sort out this confusion, let’s see what they really do.


Ice is useful when you want to reduce swelling following an injury.

For example, your ankle balloons up after a sprain. This is because blood and fluid collect rapidly, making it both painful and stiff.

At this point, an ice pack helps to restrict tiny vessels to slow blood flow. Small nerves become numb, so the pain reduces. The muscles relax. The inflammatory reaction slows down. As a result, your ankle is less swollen and painful.

Ice packs are very useful in bruises, strains and joint swellings.

Use ice for any acute swelling for the first day or two following injury (except back strains).

Ice can help later on too, when you’re back to exercising the injured part. Our friendly physiotherapists can show you how to make movements less painful and more flexible by using an ice pack before or during exercise.

How to make an ice pack

Wrap a plastic bag of frozen peas or ice cubes in a thick, moist towel. Place it on the injured part. Do not apply ice directly on skin. Check after a few minutes to make sure the skin is not red, which is an early sign of frostbite. Generally, icing for 15 to 20 minutes is enough. Repeat every 2-4 hours.


Heat packs, hot water bottles or infra-red lamps can be very useful a couple of days after an injury, and for when you have a muscle spasm.

Icing a muscle spasm contracts the muscle fibres, so they would hurt intensely. However, heat improves the circulation, soothes and relaxes the muscles by carrying away toxins and bringing in healing oxygen. Heat can comfort a back or neck strain, especially if it has been persisting for some time.

When you use a heat pack, wrap it in a towel and check the temperature so it doesn’t burn your skin.

When not to use heat

Don’t use heat if you have a painful, red or swollen joint. This increases circulation so that fluid collects, worsening the swelling and stretching or compressing the nerves and surrounding healthy tissue. This makes the injury more painful. You’d be better off icing it.

When to use neither!

Whether you use hot or cold packs, be aware that you can damage your skin and deeper tissues with careless use.

Don’t use it if you have an open or infected wound. If the circulation or sensation level is poor (e.g. diabetes), ice and heat could cause the skin to break down, get infected and worse.

But in ordinary injuries, ice and heat provide inexpensive, natural pain relief.

Still unsure??

Talk to us! We’re more than happy to give advice over the phone, email, or walk-in advice, especially if you need to get back to activity quickly, or you’ve been suffering from a particular pain for an extended time! We’ll speed up your recovery and get you moving more easily.