The Great Debate: Ice vs. Heat

Now that we’ve had our fill of political debates, it’s time for another round of scientific debates: Ice or Heat…which one should you use?

Both will help reduce pain, but there are certain injuries for which one is more beneficial than the other.

What’s better for neck and back pain — ice or heat? This experiment, conducted at a university-based emergency department, compared the effectiveness of these two common treatments. Everyone studied received 400mg of ibuprofen orally and then thirty patients were given a half hour of either a heating pad or a cold pack.

The researchers concluded that adding heat or cold to ibuprofen therapy did not change the result. Both heat and cold resulted in “mild yet similar improvement in the pain severity.” They recommend that the “choice of heat or cold therapy should be based on patient and practitioner preferences and availability.” Ice

Ice should be used for acute (sudden) pain or on a new injury that is causing swelling/inflammation. It will help numb pain and reduce inflammation. Ice can be beneficial after a work-out or when experiencing sore muscles after an intense body work session.


Heat should be used for chronic pain or an injury that is older than a day. It will help relax muscles and soothe stiff joints.

But what about a freshly injured muscle?

If ice is for a new injury and heat is to relax muscles, what happens when you injure a muscle? If it really is a muscle injury (severe, sudden muscle pain after a trauma) this is where it gets a little tricky and you’ll end up using a combination of the two. Start with ice for the first few days (usually first 48 hours is best) to help decrease the inflammation and then switch to heat to help relieve the soreness.

The bottom line is: use whatever feels best to you! Your own preference is the tie-breaker and probably the most important consideration. For instance, heat cannot help if you already feel unpleasantly flushed and don’t want to be heated. Ice is unlikely to be effective if you have a chill and hate the idea of being iced!

If you start to use one and you don’t like the feel of it … just switch to the other.

Garra G, Singer AJ, Leno R, et al. Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy. Acad Emerg Med. 2010 May;17(5):484–9.PubMed #20536800.




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