Hot or Cold Treatment for Body Pain: Which is Better?

Is it better to apply ice or heat to an injury? Well, you must first determine whether the body pain you are experiencing is caused by inflammation or constriction (spasm). Once this is determined, follow these 3 rules:

1. If an injury is acute (caused by new trauma), it is best to apply cold within the first 5 minutes to reduce swelling, inflammation and pain. Ice packs, ice cubes, a frozen bag of peas or cold gels can be applied. On for 20 minutes, off for 20 minutes, then continue as necessary.

2. When swelling is down and the pain cycle is broken, stop the cold and apply heat. This will bring oxygen and nutrient rich blood to the area to relax muscles, remove waste products and promote healing.

3. Simply put: never heat an inflamed area and never ice a constricted area. Inflammation is an expanding reaction and needs to be reduced, so cold is the answer. A spasm is a constriction that needs relaxing, so heat is the answer.

You may be asking why the answer is so simple when the debate is so heated. There can be no debate when one understands the mechanisms behind pain, spasm and inflammation and then how cold and heat applications affect them.

When pain is experienced the body sends more white blood cells to the affected area. The result is less red blood cells, less oxygen and less nutrients are available to begin the healing process. The process of retarding oxygen and nutrients causes a new “injury” to the area.

When the nervous system senses an injury it sends signals to the brain, which interprets them as “pain.” The new signal is sent to the injured area, telling the muscles to reduce blood supply in an effort to reduce swelling. However, this blood deficit causes more pain, swelling and spasms.

This cycle of pain, elevated white blood cells, lower red blood cells, excess waste material, more pain and inflammation can continue on for days, weeks, even years if not treated properly. Correct application of ice and heat is the method of treating soft tissue injuries, pain, spasms and inflammation. Incorrect application, however, can prolong the problem and make it become chronic.

While at opposite ends of the temperature spectrum, heat and cold both create a healing response. If you think of your stove and your freezer, you can easily see the result of either. Heat melts and increases surface area. Cold constricts and prevents expansion of fluids. Heat moves things along while cold maintains them in a state of suspended animation. So how do these temperatures affect the body?

Heat causes the body to circulate more blood and to remove toxins. This allows more fresh oxygen and nutrients to the injured area, which begins and continues the healing process while removing the toxins that cause scar tissue and chronic pain. Cold, on the other hand, retards swelling and reduces pain.

Both temperature extremes shut off pain signals; heat by relaxing the affected nerves and cold by numbing them. This is good because when pain signals are not sent to the brain there is no response signal generated telling the muscles to contract (spasm) in order to protect the injury site.

After proper application of heat or cold over time, the pain-spasm-inflammation cycle is broken and effective healing of the area can begin.