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Ice vs Heat from a literature perspective

Updated: Oct 11, 2023

The use of ice and heat for pain management, both acute and chronic, is a common practice in healthcare. However, it's important to note that the effectiveness of these modalities can vary depending on the type and cause of pain. Here is a review of the literature on the use of ice and heat for pain management: Ice (Cryotherapy):

Acute Pain:

  • Ice is often recommended for acute injuries, such as sprains, strains, and bruises. It helps reduce inflammation, swelling, and numbs the area, providing temporary pain relief.

  • A study published in the Journal of Athletic Training (2004) found that ice application immediately after an acute injury can help decrease pain and improve function.


  1. Chronic Pain:

    • In chronic pain conditions like osteoarthritis, ice may be less effective and even counterproductive. Some individuals find that cold exacerbates their chronic pain symptoms.

    • A review in the Journal of Pain Research (2018) suggests that cryotherapy may be more effective in acute rather than chronic pain management.


Heat (Thermotherapy):

  1. Acute Pain:

    • Heat is typically not recommended for acute injuries as it can increase inflammation and swelling. It may also cause burns if applied for too long.

    • A study in the Cochrane Database of Systematic Reviews (2015) concluded that heat therapy is not effective for acute low back pain.


  1. Chronic Pain:

    • Heat is often recommended for chronic pain conditions, such as muscle tension and osteoarthritis. It helps relax muscles, improve blood flow, and relieve stiffness.

    • A study published in the Journal of Clinical Rheumatology (2004) found that continuous low-level heat therapy provided significant pain relief in patients with osteoarthritis.


Combined Use:

  • Some studies suggest that a combination of ice and heat, known as contrast therapy, can be beneficial in certain situations. Alternating between hot and cold applications may help reduce pain and promote healing, particularly in conditions like muscle spasms.

  • A review in the International Journal of Sports Physical Therapy (2013) suggests that contrast therapy may be more effective than using ice or heat alone for certain musculoskeletal conditions.

It's important to note that individual responses to ice and heat can vary, and what works best for one person may not work as effectively for another. The choice between ice and heat should consider the specific condition, its stage (acute or chronic), and the patient's preferences and comfort. Additionally, consulting with a healthcare professional is advisable to ensure the appropriate use of these modalities for pain management.

POLICE IS THE NEW RICE!!!!!



Dan Morwood

Physiotherapist, DPT, CAFCT, CGDNT

Peak Performance Physiotherapy & Sports Rehab



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