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Writer's pictureDr. Gavin Grimaldi, DC

Heat or Ice?: Time tells the secret!

As a chiropractic physician, who specializes in working with athletes, I often encounter patients suffering from sports based injuries seeking relief. These injuries range from sprained ankles, elbow tendonitis, to the ever-so-common “stiff neck”. One common dilemma patients face in managing these conditions is deciding whether to use heat or ice for at home treatment. While both can be beneficial, understanding the difference in their effects on the body, is essential to expediting the body's natural healing process.


Heat therapy, in the form of hot packs, warm towels, or heating pads, works by dilating blood vessels, increasing blood flow, and relaxing muscles. This vasodilation (dilation of blood vessels) effect promotes healing by circulating “new” blood through the affected area, thus aiding in the removal of waste products and reducing stiffness. The one negative with heating therapy is overuse, oftentimes the tendency will be to use the therapy for hours at a time. This is exactly what we do not want to do. Ideally, 20 minutes on, 40 minutes off seems to be the best formula for success. Heat is a healer, but it must be used correctly!


On the other hand, icing, cryotherapy, or cold baths can be beneficial for acute injuries (meaning injuries that occurred less than 2 weeks ago). My personal advice to patients is to only use it within the first 48 hours of injury. Ice works as a vasoconstrictor, constricting blood vessels and reducing blood flow to the area. This can help in reducing inflammation, swelling, and pain by numbing the area and slowing down the inflammatory response. However, it's important to note that while ice can provide temporary relief from symptoms, it does not promote healing in the same way that heat does. If you are 2 weeks, a month or multiple months into your injury healing process and still using ice, you are only slowing down the healing process.


When it comes to chronic ailments, such as arthritis, muscle spasms, or chronic back pain, heat therapy is often more beneficial than ice therapy. The increased blood flow and relaxation of muscles provided by heat can help in relieving chronic pain, improving flexibility, and promoting overall healing. Ice therapy, on the other hand, may be more suitable for acute injuries or sudden flare-ups of inflammation.


While it is essential to consult with your physician to determine the most appropriate treatment for your specific condition, take this blog as a guideline for managing your injury at home.


Here's the formula:


Less than 48 hours since injury = ICE

More than a few days since injury = HEAT (20 min on/40 mins off)


In many cases, a combination of heat and ice therapy, known as contrast therapy, may be recommended to take advantage of both treatments' benefits. This alternating application of heat and ice can help in reducing pain and inflammation while promoting healing and improving overall function.


In conclusion, when dealing with chronic ailments, heat therapy can be a valuable tool in promoting healing, relieving pain, and improving overall function. Understanding the difference between heat and ice therapy and their effects on the body can help in making informed decisions for managing chronic conditions at home and expediting your healing process.


Dr. Gavin Grimaldi, DC

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