Ice or Heat? What to use when?

June 25, 2018

One of the most common questions we get asked in a physiotherapy consultation is what do I use on my injury, heat or ice? Here are some rough rules to follow.




Ice should be used when an injury is new and inflamed, on average this is the first 24 to 72 hours. Ice works by narrowing the blood vessels to the area to prevent blood accumulating around the injury; which can make the injury site quite stiff, warm and painful. By decreasing the accumulation of blood to the site, Ice on the area will accelerate healing and decrease pain. When applying and Ice Pack ensure that there is a barrier (such as a cloth) between the ice pack and your skin to prevent skin burns. Similarly, Ice packs should only be used for 20 minutes every 2 hours to prevent any injury to the skin.


  • Use ice for the first 24-48 hours of a new injury/ flare up of an old injury

  • Ice works to decrease blood flow to the area, decreasing swelling and helping to promote tissue healing

  • Use Ice for 20 minutes on every 2 hours for the first 2-3 days. Ensure there is a protective barrier such as a cloth between the skin and the ice pack.






The opposite of Ice, a heat pack will help to promote blood flow to an area, hence using heat on a new injury will encourage swelling, blood accumulation and delay healing. Heat works well for chronic injuries in which swelling is not playing a major role, such as low back pain and neck pain that have not recently been flared up. Chronic injuries often do not have visible swelling and are not warm or painful to touch. Heat encourages blood flow into and out of the injury site, this will help to provide nutrients, oxygen and remove waste encouraging the healing process. Heat also works well for tight muscles, stiff joints and arthritis by relaxing the muscles and providing pain relief. Heat packs should be warm on the skin; however it should be a comfortable warmth and not painful. If the heat pack is too hot, you many run the risk of a skin burn.



  • Heat works well for chronic conditions that are not swollen, hot or painful to touch, as well as stiff muscles, joints and arthritis.

  • Heat encourages blood flow in and out of the injury site providing oxygen and nutrients to the area while also removing waste.

  • Heat should feel comfortable on the skin and not painful, using for 15-30 minutes at a time.

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