Do I apply ICE or HEAT???

The use of cold and heat is a natural form of pain relief and an effective way to reduce inflammation and promote circulation, tissue health and healing. It is recommended as an alternative or adjunct to anti-inflammatory tablets and gels such as Voltaren and Nurofen, which have been found in some cases of long term use to cause adverse effects for some people.

There is commonly confusion as to when to use heat and when to use cold. Either may relieve the discomfort and soothe the area, which feels great at the time, however it is crucial to use the correct therapy to support your body to heal faster and more completely.  As a general guide, in an acute, or new injury (within 24 hours) it is beneficial to use ice to reduce inflammation and further tissue damage.  After this period of time, and in chronic pain, it is advised to use heat to increase blood flow and therefore increase in healthy, new blood to the damaged tissue and flow of toxic blood away from the tissue.  This will support the body in its own healing processes, getting you moving again sooner.  The old school RICER recommendations has now been replaced by POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) for acute injuries.

Please find below a table to support you in choosing the most effective therapy for your symptoms.

Why When How Precautions
– reduced pain
– reduce Inflammation by limiting internal bleeding and flood of inflammatory products to an injured area
– acute injuries, ie sprains, strains of sudden onset that exhibit pain, tenderness, redness, heat, inflammation –
– flare ups of chronic injuries and pain
– 10 minutes every two hours as practical for 24 hrs following injury
– cover ice pack, ice cubes in a bag, frozen peas with a tea towel
– avoid eyes and top of neck
– applying ice for longer than the prescribed time
– exercise or strenuous activities 30 minutes after
– sleeping with ice applied
– stimulate blood flow
– warm up the area
– helps loosen up and relax muscles by promoting blood flow away from site and therefore clear metabolites and toxins
– chronic pain, ie. dull pain and stiffness that can come and go, and arthritic conditions
– before activities that aggravate chronic injuries, ie. before exercise, getting out of bed, physical work such as cleaning, lifting and gardening
– 20 minutes to area of stiffness every 2-3 hours
– use heat pack or tea towel soaked in warm water
– applying heat for longer than the prescribed time
– applying heat up to 1hr after exercise
– sleeping with heat applied
– burns by placing towel between skin and heat

For those who have found both heat and cold effective in the past, you may choose to try to cycle both heat and cold. This can be done for up to 20 minutes. Cold 5 minutes, heat 5 minutes, cold 5 minutes, heat 5 minutes. It is important to finish with heat. This sequence is usually more appropriate for chronic pain and stiffness.

If pain persists 48hrs after an acute injury or is becoming more severe or frequent for a chronic injury, please consult your practitioner. We encourage you to contact us here at the office should you have any questions or if you are unsure as to whether to apply cold, heat or both or if treatment is indicated.

In situations where applying cold or heat is not practical such as at work or while travelling there is a couple natural approach to anti-inflammatory creams and supplements that we use in the clinic, including Fisiocrem and Traumeel gel and tablets, Blue Ice Gel (DoTerra) which are homeopathic/herbal/essential oil based products (caution in pregnancy) that reduce swelling in the joints and soft tissues resulting from sporting injury, joint restriction, arthritis and repetitive strain symptoms.

Taking the time and attention to manage acute and chronic injuries can make a significant difference in how the body responds, heals and ultimately, recovers.

If you have any questions regarding your symptoms or would like to book a consultation with one of our experienced practitioners or to pick up some cream or supplements, please contact us on 3208 8308, or drop in and visit us.

Written by Dr. Jess Harvey B.Sc. (Anat, Phys), B.Ap.Sci (Comp. Med.), Ma Osteo., Registered Osteopath and Director of Head 2 Toe Health, a multidisciplinary clinic in Brisbane also providing Acupuncture, Massage, Life Coaching and Counselling – where we aim to get you as well as possible, as fast as possible, permanently. We believe in a thorough approach to restoring and maintaining health and address many aspects of our lifestyles that can contribute to pain, stiffness, dis-ease and disease. For any further information, please contact us on or 07) 3208 8308.

This information is intended as a general guide only and is not specific for any particular condition or situation.