Our Ask A Physio series is a collection of microblogs aimed at giving a basic understanding of some frequently asked questions. If you have an injury or are experiencing discomfort please book an assessment or contact reception for more information.
This is actually a topic of pretty intense debate, even after all of these years! We know that both heat and cold can provide good pain relief, so the difference really comes down to timing. In a fresh injury, I usually advise ice in the first 72 hours, as local of an area as possible, and for about 20 minutes three times a day. Beyond this, the research seems to say that going over the top with ice can actually slow down healing.
The side note here would be about ice baths for recovery, which come and go with other exercise trends. There’s no good evidence that ice baths speed up your recovery or make muscles work any better. They do however improve your perception of how well you’ve recovered after a big workout. The good old placebo effect maybe? If you’re going to give it a go, make sure to check in with your GP or physiotherapist first, and always have someone else around to help you.
After the first couple of days, I think heat makes more sense. It drives blood flow and nutrition to a healing area and can be really soothing, particularly for back pain. Heat can also make your soft tissues softer, potentially making moving and stretching a bit easier. Similar to the ice, I would recommend 20 minutes three times a day, just with a simple hot water bottle or wheat bag. One thing to be careful of here is that painful areas can sometimes lose their sense of hot and cold, so make sure that your skin doesn’t get irritated, and check the heat with an injured hand before you apply it.