Ice vs Heat - The battle rages on

Apologies for the very basic nature of the picture but it gets the point across does it not? Anyway, moving on from my technological incapabilities!

I frequently get patients getting confused about whether it is best to use ice or heat application for their problems.

They are aware of the benefits of heat but not necessarily why ice can be useful sometimes. Well, not to brag or anything but I did my dissertation, in brief terms, about the benefits of ice application for certain problems so I'm a firm believer in it.

HOWEVER, heat application certainly has it's place too! On that note - here is a basic breakdown of the reasonings for either Ice or Heat application for your particular problem.

To start with I'm going to give a brief explanation of the inflammatory process as this will help you to better understand.

The 4 signs of inflammation

Pain - generally caused by the irritation of the nerve endings

Swelling - fluid full of healing factors leaks from the blood vessels in the affected area, this also creates a movement restriction which helps to stabilise the area

Redness - blood vessels widen to allow more blood flow to the area

Heat - the blood flow also brings heat



It is a well researched fact that ice application helps reduce inflammation and thus reduces pain. This is because it causes the blood vessels to narrow which restricts the blood flow and limits the build up of fluid in the area.

The difficulty comes in saying definitively how long you should apply it for so I personally tend to say 10 minute intervals as it seems to be a repeated suggestion throughout a lot of research papers.

This is often why I suggest using ice if it is sore after treatment, simply because the nature of the treatment may stimulate some inflammation and cold can help reduce the effects.


The risk with ice is, as with heat, leaving it on too long can cause more harm than good. Skin damage is something to be aware of if a cold compress is left on an area for longer than 20-30 minutes. The other thing is that if the ice is left on there for too long and the area gets very cold, the body's natural response is to send blood to it to warm it up. This can then kickstart any inflammation again and may make things feel more uncomfortable - essentially undoing the good that it would have done.



Heat is marvellous for helping tight muscles and tension.

This flow chart explains what happens when muscles are tight:

Muscles get tight --> constriction and restriction of blood flow --> reduces drainage and limits nutrient and oxygen supply

Heat application causes the blood vessels to widen, thereby improving this drainage and nutrient flow and consequently helping the muscle to relax.


Again, there is the risk of skin damage if left on an area for too long so make sure you do not apply heat or ice packs directly to the skin! 10 minutes at a time is usually what I suggest.

If the area is inflamed, as you have seen above, adding heat to it may just encourage further inflammation, thereby making it feel worse.


Ice = for inflammation

Heat = for tense muscles

#ice #heat #osteopathyworks #aftercare #research

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