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​Treating pain with heat or cold compress

​​​​​​​​​​​​​​​Ice versus heat: An age-old question.

Applying heat may sound like a great treatment for a sports injury. Despite how good it may feel, heat may not be the most efficient way to promote healing. How do you know when to use ice and when to use heat on a sports injury? This age-old question can be answered best after taking into account the type of injury (acute versus chronic) and the timing of treatment (before or after the workout).

An acute injury is one that has occurred within the last 48 hours. It is usually the result of sudden trauma, such as a fall or collision. Signs and symptoms of an acute injury may include pain, tenderness, redness, warm skin and swelling. Chronic injuries differ from acute injuries. They usually develop slowly because a body part is being overused or because an acute injury has healed improperly. Pain from a chronic injury may not be constantly bothersome, but it can come and go in the form of soreness or dull pain.

Ice is the recommended treatment for acute injuries. It is especially helpful to reduce swelling and control pain. Ice is most effective when it is applied early and often for the first 48 hours.

Heat, on the other hand, increases circulation and raises skin temperature. For these reasons, it should not be applied to acute injuries, or injuries that show signs of inflammation. Heat is great for sore muscles and joint pain, which are typical of chronic injuries.

Although ideal for chronic injuries, the timing of when to apply heat is important. Athletes with chronic injuries should apply heat before exercise to increase flexibility and to stimulate blood flow to the area. After exercise, ice is the best choice for a chronic injury because it discourages the onset of swelling and pain.

Follow this quick guide for using ice or heat for sports injury:

Use ice

After an acute injury, such as an ankle sprain, or after activities that aggravate a chronic injury, such as shin splints.

Use an ice bag with cubed ice, ice pack or ice massage. When using an ice pack that does not have real ice cubes, use a thin towel between the ice pack and the skin to prevent frostbite.

Do not use ice longer than 20 minutes at a time. More time spent icing does not mean more relief. Be sure the area goes numb, then make sure the skin returns completely back to normal before reapplying.

Use heat

Before activities that aggravate​ chronic injuries, such as muscle strains. Heat can help loosen tissues and relax injured areas.

Apply heat using a heating pad or a hot wet towel.

No more than 20 minutes at a time. Never apply heat while sleeping. Be careful not to burn yourself.

Share comments or questions on this information. E-mail sports.medicine@marshfieldclinic.org​.​​​

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