Our physiotherapists at Sorrento are regularly asked whether an ice pack or heat pack should be applied for sports injuries and for back and neck pain. Most people use ice for acute injuries but do they apply it for long enough or often enough? The debate between ice and heat for pain and injuries continues to baffle many. Allow My Physio Perth to dispel some myths about the application of ice and heat and answer some frequently asked questions.

Deep Heat or Heat Packs?

This is a simple blog to assist you in making an informed decision between applying ice or heat to your painful or injured body part.

For more extensive information regarding ice therapy, please read my previous blog To Ice or Not for Acute  Injuries.

Are you suffering from an acute injury or from chronic pain?

If you can answer this question, you are well on your way to making the correct decision about applying ice or heat to your painful area. If in doubt, seek expert advice from our physiotherapists at Sorrento.

Acute Injury

When you suffer an acute injury (new injury), you generally sustain tissue damage. Damaged tissue causes swelling, which increases pain. There is debate about whether we should allow this natural process to occur without intervention but the general consensus is to prevent excessive swelling. You should apply ice to these common acute injuries:

Joint sprains/ligament tears

Muscle strains/muscle tears

Muscle corks/haematomas/bruises

Joint dislocations and subluxations

Bone fractures (if comfortable)

Chronic Pain

If you have suffered an ache or pain for months, you are unlikely to have a significant active inflammatory reaction in process. In fact, your body may have skipped past the normal inflammatory stage without complete resolution or healing. The application of heat to a body part increases blood flow and tissue temperature. Heat reduces pain and improves tissue extensibility or flexibility. You should apply heat to these common aches and pains:

Chronic neck pain or stiffness

Chronic back pain or stiffness

Postural related aches and pains

Persistent aching post surgery (ice for the first few weeks)

How long should I apply ice to my injury?

You should apply ice to your injured body part immediately. It is widely accepted that an ice pack should be applied for 15-20 minutes at a time. The application of ice can be repeated every 2-3 hours. Ice should only be used during the inflammatory stage, which usually lasts 2-3 days. If you are unsure whether to ice your injury, please see your physio at My Physio Sorrento.

The exception to the rule: Acute back and neck pain.

Back and neck pain is commonly triggered by stress to the structures of the spine including joints, ligaments and discs. It is difficult to heat or cool these structures as they are quite deep below the surface of the skin. When the spine is stressed, it is very common for the muscles to spasm, causing further pain and stiffness. Muscle spasm causes constriction of blood vessals and therefore reduces blood flow. Applying an ice pack to a painful neck or back tends to be uncomfortable, causes further muscle spasm and stiffness. Therefore, our Sorrento physios recommend applying heat if you have neck or back pain, regardless of whether it is acute or chronic. Heat will ease the muscle spasm, improve mobility and is unlikely to penetrate deep enough to have a detrimental affect on the injured structure.

5 Tips to Manage Low Back Pain

Summary

Ice all acute injuries except for back and neck pain. Apply the ice for 15-20 minutes every 2-3 hours for the first 2-3 days.

Heat all chronic aches and pains as required for pain relief and improved flexibility.

Heat all acute and chronic back and neck pain.

Book an appointment with your expert physio at My Physio Perth’s Sorrento clinic to assist in the resolution of your acute and chronic injuries.