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Ice vs Heat

Which one should I use and when to use it?

One of the most common questions that medical and rehabilitation professionals receive is if, “an ice pack or heating pad is better for me to use.” The answer to that question varies, and is dependent on the type of injury you may have.

This information will help you understand in what scenario heat or ice is more appropriate and under what circumstances you should use either. However, we do recommend asking your primary care physician or your rehabilitation care provider, like a physical therapist, what is best for your specific needs.


It is very important that if you have any:

  • Swelling

  • Easily irritated skin

  • History of DVT’s

  • Areas of numbness

You should not use a heat pack due to the negative effects and harm it could cause you. If none of the previously stated “red flags” apply to you, that is great! If you feel like your muscles are tight and achy and/or you feel like your muscles are not moving as well as they normally do, heat would be a great option to help you recover from your injury!


Like with heat, there are instances where using ice or a cold pack should be avoided due to adverse effects when a person has:

  • Poor circulation or numbness

  • Easily irritated skin

  • Peripheral Vascular Disease (PVD)

  • Advanced diabetes and/or neuropathy

  • Raynaud's Disease or Lupus

If any of these conditions listed describe you, then do not use an ice/cold pack as it could cause negative effects. Using an ice or cold pack would be recommended if you are dealing with: swelling, muscle spasms, first degree burns, or in an area where muscles are tender to touch due to soreness, pain, and/or increased sensitivity.

Something important to note with the use of both heat and ice is that either pack should never directly touch the skin, the intensity of the heat or cold could cause a burn or skin damage. So, with both use a barrier, such as a bath towel, between your skin and the hot/cold pack. And always remember, the most highly recommended thing that you can do before using a hot/cold pack is to consult your medical provider. If an injury persists and does not resolve, a medical evaluation by your primary care provider or with your direct access physical therapist would be the best option to determine an appropriate treatment plan.


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