Hot vs. Cold – which is best?

Hot or Cold for Sprains and Strains?

Confused about whether to put a hot pack or ice on that injury? You’re not alone – this is a commonly asked question. Cold and heat both have their place in the rehabilitation process. When used correctly, each can help to reduce pain and control swelling and assist with tissue healing. When used inappropriately, they may delay healing. So how do you know which to use?

Cold Therapy
This includes freezer gel packs, ice cubes or an ice bath. Cold can be applied in the first 24-48 hours after injury (during the “acute” phase). Cold causes constriction of blood vessels which will limit the amount of swelling that develops. It also slows nerve conduction and decreases skin temperature which will reduce pain. Cold can also be used after the first 48 hours if inflammation continues or after exercise to help with soreness. Wrap the cold pack in a damp towel to prevent frostbite on the skin and apply to the injured area for 10-15 minutes.

Heat Therapy
This includes hot water bottles, electric heating pads or moist heat packs. Heat causes dilation of the blood vessels which increases blood flow to the area. This assists with removal of waste products and delivery of oxygen and nutrients to promote healing. Wrap the heat pack in a few layers of towel to prevent burns and apply to the affected area for 15-20 minutes. Do not lie on the hot pack or apply when going to sleep as this increases the risk of burns.

Although the use of heat is commonly applied for ‘chronic’ issues, heat can also be used early in the recovery process to help reduce pain, improve muscle tension and swelling. In fact, the use of heat is preferred where you want to promote blood flow and circulation. However, avoid applying heat on areas that are inflamed (warm to the touch, increased redness and obvious swelling).

While cold and heat can both be beneficial, they should not be used, or used with caution if you have:
• Impaired circulation
• Reduced skin sensation
• Hypersensitivity or allergic reactions to cold
• Open or infected wounds, or acute dermatitis or eczema
• Malignant tumours or active tuberculosis lesions

If you have questions about whether to use hot or cold, or if you are unsure about the nature and severity of your injury, get in touch to book an appointment with our physiotherapist. Our clinic is conveniently located at Dundas and Trafalgar in Oakville.