01322 275 402
West Hill Physiotherapy, Tower Road, Dartford, Kent, DA1 2EU [See map]
Facebook Twitter Youtube

Should I be using Hot or Cold to treat my aches and pains?

hot or cold treatment

What should you use to treat an acute injury? Ice/cold or heat packs? We have been asked this question a lot recently so here is the answer. Follow this advice and you won’t get it wrong again:

Imagine that you have just twisted your ankle, pulled your hamstring running or felt a muscle pull in your back after lifting something. All of these injuries are acute.

Depending on the severity of the injury there will be some swelling or localised bleeding in the tissues. There will also be inflammation. The inflammatory process is a good thing when you have just injured yourself as it initiates the healing process. However, we don’t want the tissues to stay inflamed for too long as this will continue to cause pain and discomfort.

You should always apply cold to an inflamed or recently injured area. The reason being is that you want to stem any bleeding in the injured area and reduce the swelling. Applying cold will cause the blood vessels to constrict which will reduce blood flow to the area and help squeeze the swelling out and away from the damaged area. Applying heat will do the opposite and dilate the blood vessels and promote blood flow thereby increasing swelling and bleeding.

How can you tell if the tissues are inflamed?

Lets take an example where you have just pulled a muscle in your back. Place the back of your hand over where you feel the pain. Does the area feel warm to touch or hot? If so the tissues are inflamed. Sometimes the type of pain you are experiencing can give you a clue. An inflamed area is normally experienced as a dull throbbing ache. You may have difficulty finding a comfortable position. Something inflamed will normally get worse the more you move i.e by the end of the day. A third clue is to apply some pressure to the area of pain. Keep the pressure on for about 30 seconds and note if there is any change in the sensation or pain. If the pain stays the same or gets worse the tissues are inflamed. In this case do not try and stretch, apply an ice/cold pack and avoid rubbing or massaging the area.

How long should you apply the cold pack?

Okay safety first – never apply ice directly to the skin as this can cause an ice burn – your injury is painful enough as it is! Always wrap the ice pack in a damp tea towel before applying to the skin.

The recommended duration of time is between 10 and 20 minutes. If you are only treating a small area aim for 10-15 minutes. After this time remove the cold pack and allow the tissues to return to normal temperature. Once they have you can go right ahead and apply the cold treatment again. You can follow this process as often as you like throughout the day as the majority of people will find the cold pack very relieving.

When can you move over to using heat?

We normally recommend using a cold pack for this first 48-72 hours after an injury. After this time you can move to using a heat pack – normally applying heat for 20-30 will be sufficient.

So should I always use cold/ice packs?

If you really are not sure then always go with a cold pack first. You will not cause any damage. Applying heat to an inflamed area will make the pain worse by increasing any bleeding and swelling in the area.

So in summary…………………..

Cold packs:

physio cold therapy

  • As soon as possible after an acute injury
  • If applying pressure to the painful area increases the pain felt
  • If the painful area feels hot to touch
  • If you find the pain gets worse throughout the day or you are finding it difficult to get comfortable.

Heat packs:

physio heat treatment

  • After exercise and your muscles feel a bit stiff and sore
  • If your muscles ache but the ache is not throbbing
  • If your injury is more than 72 hours and you have already applied ice/cold packs

If you want any more advice or want help in managing and treating an injury that is not getting better please get in touch with us. You can either email us at info@westhillphysio.co.uk or by phone on 01322 275 402





Man receiving shoulder treatment
Our primary focus is restoring normal function and maximising your potential.
More »

Sports Injuries

Footballer with knee pain
We are experts in aiding the recovery and rehabilitation process for a wide range of sports injuries.
More »


Patient receiving ankle treatment
We specialise in providing acupuncture treatment to help treat and prevent injuries and pain.
More »