Ice or Heat?

Acupuncture Health and Wellness

Posted by julia

You are in pain. Do you use ice or heat ? There are lots of opinions on this one.

Most Western practitioners use ice, while most Eastern practitioners use heat. What’s the reason? How do you know when to use ice and when to use heat? Read on to find out these answers and my 2 rules of thumb on the heat vs. ice debate.

Ice Freezes Things

If you are an injured athlete, it’s common practice to take an “ice bath” after a hard game or practice. Athletic trainers, physical therapists, chiropractors, and MD’s recommend RICE (rest, ice, compression, elevation) for injuries because it decreases inflammation and pain and speeds up the healing process. Ice makes blood vessels constrict which decreases inflammation. Cryotherapy is the new ice bath, where you go into a cryotherapeutic chamber of extreme cold for 3-4 minutes. You are standing up during this treatment in something similar to a spray tan booth. This dramatic change in temperature causes a huge release in adrenaline, boosting the immune system, decreasing pain and inflammation, among other benefits. I am always interested in new treatments and would actually really love to try this even though I hate being cold!

Acupuncturists do not usually recommend ice for any injury because ice freezes things. It limits circulation to that area, therefore limiting fresh oxygen, nutrients, and helper cells to clean up the injury. In the short term ice may feel good because it numbs the pain, but in the long term ice makes things stiff and usually more painful. In Chinese medicine you always want to keep things circulating and moving so your body can eliminate the stagnant qi and blood, and bring fresh blood and nutrients to the area for repair.

Heat Promotes Circulation.

Everything that you need in your body to heal itself is in your blood . By increasing blood to the area of injury, you are naturally allowing it to heal faster. This is one of the basic premises of why acupuncture works so well for injuries. Heat promotes circulation, or blood flow, to the area treated. Heat also relaxes tight muscles and tendons, which increases range of motion and flexibility. 

Rule #1: Ice for Sudden / Acute Injuries

Some of my Chinese medicine colleagues would freak out that I was suggesting to use ice EVER, but I do think ice has its place. When I partially tore both my Achilles (at the same time!), I tried heating them first which irritated the injury and made it worse. I usually recommend ice for acute injuries or flare-ups of tendonitis and other painful, swollen, red or hot injuries. I don’t typically recommend ice on muscles, except when it’s an acute situation – which you will know because its sudden and severe pain. If this is the case, use ice for 24-72 hours after the injury, and then switch to heat, or alternate heat with ice.

* Treatment for Ice: 15-20 minute sessions, always use a cloth in between you and the ice to not get frostbite or tissue damage, can do 3-4 times per day the first 2 days, then switch to heat or alternate with heat as needed

Rule #2: Heat for Chronic Injuries and Muscle pain

I love heat. Heat increases circulation to the area, relaxes tight muscles, eases pain, and just feels so good. Heat also calms the nervous system and reduces stress and anxiety. I use heat with almost all muscle injuries, including chronic injuries and acute minor muscle strains. I like wet heat like Jacuzzis and wet heat packs which penetrate heat deeper. Plug-in heating pads are usually more accessible for people to use which are great to use as well. Just be careful not to sleep with a heating pad, and also not too hot which can burn your skin. Especially be careful of skin burns if you are applying topicals like pain sprays or liniments/plasters and then heat on top of that.

* Treatment for Heat: 15 minutes up to 2 hours, depending on your condition and tolerance. Start short and see how it feels. Some people apply heat patches under their clothes and wear them all day, others stick to heating pads or Jacuzzi at night.

In a nutshell: Listen to your body. Try ice and heat, and see what feels better. If you aren’t sure, use ice for new injuries that are painful, swollen, red, or hot. Use heat for chronic pain or minor sore muscles, and for relaxation and stress relief.

I hope that helps in the heat/ice debate, and feel free to consult your health practitioner for your own specific needs. My goal is to help you recover faster by using any modality that works best for you. As always, listen to your body and do what resonates and feels good to you.

Best in Health,


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