When To Use Ice Or Heat (From Back Pain To Bruises)
ice or heat for pain injury

Ice or Heat?

Not sure if you should use ice or heat for your pain or injury? 

You’re not alone! 
There is so much confusion around when to use ice and when to use heat, and this is a common question we are asked here at Phyx.

Ice or heat for back pain? Ice or heat for bruises? Both ice and heat are wonderful to aid healing when used correctly. 

The general rule is you use ICE for injuries and HEAT for muscular pain/tightness.

Why Use Either?

Our bodies naturally adapt to changes in temperature for survival through regulating blood flow by dilating (widening) or constricting (narrowing) blood vessels. 

When we apply heat or ice, we are taking advantage of the natural reactions of our bodies to help reduce pain and promote healing of injuries.



Applying ice to your body has the effect of constricting your blood vessels. 

This helps reduce the blood flow, subsequently reducing swelling, internal bleeding and pain.

This is why ice is helpful for injuries such as an acute sprain or strain, acute muscle tears, suspected fractures.
Aside from acute injuries, ice is also useful for reducing post-sport muscle soreness and swelling in athletes,  and for post-activity inflammation to reduce pain, inflammation and swelling associated with repetitive/overuse injuries, such as chronic bursitis or tendinopathies.


Applying heat to your body has the effect of dilating your blood vessels. 

This helps to increase blood flow, reducing muscle tension or spasm, pain and stiffness, and improving soft tissue elasticity.

Heat is useful for areas which are stiff or have muscular pain, such as back or neck aches (not associated with acute trauma), muscle spasms, muscle trigger points, chronic pain, arthritis.

Prior to sport or activity, heat can be used to promote the warming of muscles, ligaments, tendons and joints to reduce the likelihood of injuries.

How Should You Apply Ice / Heat?

The most common way to apply ice to an area is via an ice pack.

  • Wrap the ice pack in a wet cloth or towel to protect your skin 
  • Avoid applying it directly onto your skin as this can cause burns
  • Ice area for 10-20 minutes

Ice baths/buckets can be used to treat areas including hands, wrists, ankles and feet.

  • Fill a container with ice cubes and cold water
  • Submerge the area or limb in the water for 10 minutes
  • If this is too cold, dip the limb in and out over 10 minutes


The most common way to apply heat is with a heat pack or hot water bottle.

  • Use a heated bag or hot water bottle wrapped in a cover
  • Ensure heat is gentle and comfortable
  • If a heat pack or hot water bottle is too hot it may burn your skin
  • Apply heat for 20-30 minutes

Can I Use Heat and Ice?

The alternate application of ice and heat is called contrast therapy.

Alternately applying ice and heat to your body causes continued narrowing and widening of the blood vessels.

Contrast therapy is good for general recovery after sport or activity and is thought to reduce and prevent post activity swelling and muscle soreness.

Contrast therapy can be applied using a bucket filled with warm water and a bucket of cold water,  or more simply, using hot and cold showers.

  • Alternate between buckets (or showers) every 3-5 mins for a total time of 20-30 minutes
  • Finish on cold

If you are unsure of which method to use for your injury, pain or circumstance, contact your local physiotherapist or a health professional for further help and advice.

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