A woman holding an ice pack on her injured knee.One of the common questions that I get asked as a physiotherapist is, “what should I use: heat or ice?”. Some people feel uncomfortable with ice and love the heat, whereas others feel completely opposite.

Today’s blog is going to answer that question and clear away some confusion around this debate.

What Does Heat Do?

Superficial heat (heating pads, hot water bottle, hot packs) aim to increase the temperature around the area that they are applied. They increase the blood circulation around that area, leading to increased blood flow. Increased blood flow brings in more oxygen, washes away the pain-causing toxins, helps with tissue healing and therefore, and helps reduce pain.

What Does Ice Do?

Superficial cold has the opposite effect by cooling the area. In the initial few minutes of application of ice, the blood flow reduces due to the coolness of the pack (first 10 minutes). Following that, the cold causes the blood vessels to increase in size, increasing the blood flow to the area. They reduce the metabolic rate, hence reducing the swelling and pain.

When Do I Use What?

When deciding between heat and cold, it really comes down to the timeline of your injury. Due to the effect an ice pack has on your tissue, an acute injury will benefit from it. In fact, using heat on an acute injury could actually be detrimental, as it increases swelling (which you don’t want!). The first 48 hours after the injury are usually the best for icing. You can use a pack of frozen peas, a cold pack, or a frozen gel pack to apply – just make sure you wrap it in a piece of cloth before application.

Once the swelling has subsided, or if it’s a chronic condition with pain and tightness, heat can be used to relieve that. In fact, if pain is one of the major concerns, either heat or cold can be used – it really comes down to what makes you feel better!

How Do I Know I Can Use Heat?

In general, just be aware of the signs of inflammation around the area you are treating. If you see redness, swelling, increased temperature with pain (compared to the non-injured/non painful side), you most definitely want to go with the cold!

We hope this helps you make the right decision. If the pain doesn’t subside even after using heat or ice, it would be a good idea to see your physiotherapist for a quick assessment to find out what’s going on!


Footprint Health and Wellness Centre is a multi-disciplinary clinic located in South Barrie, offering chiropody, physiotherapy, and massage therapy services. Book your appointment now!

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Jasleen Grewal

About Jasleen Grewal

Jasleen Grewal is a trained Physiotherapist with 4 years of experience. She completed her Bachelor's in Physical Therapy in India and went on to take up her Master's (Neurological) in the same, from England. She has since been treating patients with a variety of orthopaedic and neurological conditions. She also holds multiple certifications in manual therapy from India.