Ice vs. Heat For Pain

PT Northwest Blog featuring the benefit of heat vs. ice for injury

Ice vs. Heat

Frequently, we’re asked at PT Northwest about whether to use ice vs. heat for an injury. To simplify things, here are some general guidelines to consider. However, it’s crucial to remember that if you have conditions such as fibromyalgia, Reflex Sympathetic Disorder (RSD), or rheumatoid arthritis, your sensory pathways might not respond in the usual way, requiring personalized approaches to pain management. If you find yourself navigating these complex paths, know that we’re here to offer guidance and support tailored to your unique needs.

Typically, ice is for injuries and after activity and heat is for loosening and relaxing tissues, used before activity.


  • Photo of patient icing a shoulder injury, featuring the benefit of heat vs. ice for injuryThe first 24 – 48 hours after an acute injury onset, use ice. This is true even for simple muscle sprains or pulls.
  • After an activity, at the end of the day or when swelling is present, use ice. When things are inflamed, the more you do throughout the day, the more inflamed the area will get. Ice will assist in decreasing pain, inflammation, and swelling.
  • Ice can also be used for chronic conditions like overuse injuries to help control inflammation.

Ways to Ice:

Things to know about icing:

  • Don’t ice for more than 20 minutes
  • Let your tissue fully warm back up before re-icing
  • 20 minutes on, 40 minutes off is a good rule for icing multiple times
  • If you’re icing in an area with superficial nerves (elbow), don’t ice for more than 10 minutes
  • Don’t ice before an activity. You want your muscles warm, not cold!
  • Ice can aggravate symptoms of tightness and stiffness.


  • Heat is typically used to help relax or loosen tissues.
  • Heat will bring more blood flow to the area.
  • Heat is usually used in conditions that are more chronic. This helps stimulate blood flow to the area.
  •  Heat, when needed, is used before activity assisting more blood flow to help loosen and relax the muscles.

Ways to Heat:

  • Heating Pad
  • Hot, wet towel
  • Rice heating pack

Things to know about heating:

  • Avoid heating for long periods
  • Don’t use heat when sleeping to avoid burns
  • Heat can make inflammation significantly worse.

Remember, if your pain persists beyond a few days, it’s important to seek professional help. Don’t hesitate to schedule an appointment with PT Northwest. Our experienced team can evaluate your injury or pain and develop a customized treatment plan to get you back on your path to recovery. Your journey to wellness is our priority, and we’re here to support you every step of the way.