A quick guide that explains when to ice, when to heat, when not to, and why. There is so much confusion about this issue. It’s a shame because therapeutic icing and heating — cryotherapy and thermotherapy — are rational, cheap, easy, safe self-treatment options for many common painful problems.
Ice is for fresh injuries, and heat is for stiff, aching muscles. Roughly. But the devil is in the details, and there are a lot of them.
Ice is for injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process … that also happens to be incredibly painful and more biologically stubborn than it needs to be. Icing is mostly just a mild, drugless way of dulling the pain of inflammation and taking swelling down a bit… we hope. 2 Examples: a freshly pulled muscle or a new case of IT band syndrome (which is more likely to respond than the other kind of runner’s knee, patellofemoral pain, because ITBS is superficial and PFPS is often a problem with deeper tissues).
Heat is for muscles, chronic pain, and stress — taking the edge off symptoms like muscle aching and stiffness, which have many unclear causes but trigger points are probably one of the usual suspects. Chronic pain, especially back pain, often involves lots of tension, anxiety, hypervigilance, and sensitization, and comfortable heat can soothe a jangled mind and nervous system. Stress and fear are major factors in many painful problems, of course.