Updated: May 26
In my practice, people frequently ask whether to use an ice pack or a heating pad for pain. The answer depends on what's causing pain and how your body reacts. Inflammation is treated differently than a trigger point, and bodies respond differently to heat than cold.
Because heat works so well on sore muscles, I incorporate heat therapy into nearly every massage session. Not only does it help to soothe intensely contracted muscles, but most people think it feels nice, too. Of course, ice packs and other cold therapies have their place, but I prefer ice to treat acute injuries. Let's dive deeper into when to use ice packs and heating pads.
Inflammation Vs. Trigger Points
Inflammation is a response to tissue damage, such as an injury or infection (think of a sprained ankle or an infected ingrown toenail.) When tissue cells are damaged, the blood vessels dilate, and immune cells are attracted to the area. This immune response is your body's attempt to fight off harm. Inflammation presents as pain, fever, redness, and swelling.
As far as the scientific community knows, a trigger point, or "knot," is a section of constantly contracted muscle. The tissue is not damaged, just overused. For the most part, trigger points don't cause an immune response (fever. redness, and swelling.) If you want to learn more about the science of trigger points, check out Pain Science.
What do heating pads and ice packs do to the body?
Heat is a vasodilator, meaning it makes our blood vessels wider. Wider blood vessels allow more blood flow into the area, helping to speed the healing process by providing oxygen and nutrients. Heat also helps eliminate waste products from overtaxed muscles, helping them relax.
Cold is a vasoconstrictor, meaning it makes our blood vessels smaller. Smaller blood vessels allow less blood flow to the area, helping to control swelling and prevent bruising. Ice packs can also numb nerve endings, helping to dull pain.
Heating Pads and Other Heat Therapies
You can use a heating pad or hot compress, a paraffin wax treatment, warming topical creams, hot stones, a sauna or steam room, or take a hot shower or bath.
Heat therapy can be used to treat:
Muscular pain, soreness, and trigger points.
Muscle spasms and cramps.
Micro tears and built-up lactic acid after a workout.
Some chronic conditions like arthritis.
Ice Packs and Other Cold Therapies
Different types of cold therapy are used in sports medicine and injury rehabilitation. For example, athletes often use ice baths to recover from intense training sessions. Personally, I'm a big baby, and I can't handle an ice bath.
But some options aren't quite as intense as an ice bath. Other types of cold therapy include cooling sprays, topical cooling gels, ice packs, cold stone massages, and whirlpools.
Ice packs can be used to treat fresh injuries less than 72 hours old, like:
Experts advise limiting your exposure to heat and cold therapy to 20 minutes at a time and waiting an hour before reapplying. Also, be careful when using heat or cold treatment, as heat can exacerbate inflammation, and cold can aggravate circulatory problems.
Never place an ice pack directly on your skin. Instead, always use a thin barrier like a shirt or towel to prevent damaging tissue or causing frostbite.
When using heat therapy, the temperature should never be hot enough to burn your skin.
You should NOT use a heating pad or an ice pack on an open wound like a cut or burn. And, as always, stay hydrated.
Until Next Time
If you're unsure which one to use, try both to see what works best for you. You can also try alternating between ice and heat. Contrast baths are another great way to treat pain.
If you're in pain often, improving your health can help no matter the cause. So I created a free downloadable PDF, 5 Easy Steps to Better Health, to help you become a healthier version of yourself. So grab your copy and book your next massage to take charge of your pain.