PTC Blog

As a Physical Therapist I get the question all of the time: “Should I use heat or should I use ice?”.  Both can be used for pain relief, but different mechanisms are used to achieve the end result. Here is a quick an easy break down of when to use heat vs. cold.


  • Heat increases blood flow by opening up blood vessels. Heat can also help relax tight muscles and decrease pain.
  • Heat should never be placed on an injury that is less than 3-4 days old. It is usually used for more persistent injuries.
  • Heat is more appropriate for persistent injuries such as tension headaches or chronic low back pain.
  • Heat should also never be used if there is swelling or bruising, as heat increases inflammation and will make swelling worse.
  • Heat should be applied for 15-20 minutes and never applied directly to the skin.  Use towels between the hot pack and skin to help prevent burns.
  • Wait at least an hour between treatments.
  • Check skin during treatment to avoid burns.
  • Do not use if you have poor circulation or poor sensation in the area due to increased risk of injury.


  • Ice decreases blood flow by constricting blood vessels. Ice can also be used to decrease swelling and inflammation, which can decrease pain.
  • Ice is used for acute injuries to decrease swelling and bruising.
  • Ice is appropriate for injuries such as post surgery, sprains, strain, bumps, burns, and bruises.
  • Ice can also be used to treat chronic conditions depending on the person’s preference.
  • Ice should be applied for 15-20 minutes and also should never be applied directly to the skin. Use a towel between the cold pack and skin to avoid frostbite.
  • Wait at least 1 hour between treatments.
  • Ice can be used in addition to elevation to help decrease swelling after acute injuries.

When in doubt it is usually safer to try ice first, if you do not see results then try heat. You can also alternate between heat and ice. Always make sure to wait at least 1 hour between each. Hopefully this helps you figure out whether heat or ice is more appropriate for your symptoms.

If you have more questions give us a call at 1-888-THERAPY and we will be happy to help!

Rebecca Varoga, PT, DPT
Physical Therapist
Isanti Physical Therapy

July 25th, 2018

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