When to Use Heat or Ice for Knee Pain

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Depending on the situation, both ice and heat can be effective and convenient options for easing the pain in your knees. Because each treatment affects your leg in different ways, however, it is important to consider your specific condition before selecting one or the other. By better understanding the benefits and risks of each treatment, you can appropriately choose the option that is right for you.

man icing knee

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Causes of Knee Pain

While there are numerous different problems and conditions that can lead to pain in your knee joint, some are more frequently seen than others. Among the most common causes are arthritis, cartilage tears, sprains or strains, and tendonitis.

Arthritis

Arthritis, or “wear and tear” in the joint, occurs when your cartilage (the tissue that coats the end of the bones in the joint and helps you absorb force) begins to thin and wear away. This condition typically occurs in middle and older-aged individuals, though it can happen to younger people who are overweight or after a traumatic knee injury. People with arthritis generally experience knee pain, stiffness (primarily in the morning and after a long day), and swelling in the joint itself.

Tears

The cartilage in your knee, namely your meniscus, can also tear following a traumatic injury. This usually happens after a “plant and twist” movement that may occur while playing sports or performing more physical tasks at home or work. In addition to joint soreness, a cartilage tear can also lead to locking of the knee, limited range of motion, swelling, and giving way of the leg.

meniscus tear causes

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Sprains or Strains

Knee sprains or strains occur when a structure in the joint (a ligament for a sprain and a muscle tendon for a strain) are overstretched or torn following a traumatic injury. While many different sports and activities can cause a sprain or strain, sudden twists or direct blows to the knee are fairly common mechanisms. Depending on the severity of the injury, these issues can cause knee pain, leg instability, and significant bruising or swelling to occur.

Tedonitis

One other common knee problem that can lead to pain is tendonitis. This issue, which occurs when the tendons become irritated and inflamed, is usually the result of muscular overuse during activities like running, jumping, or biking. The knee pain associated with tendonitis typically comes on gradually. Initially, it may only be present while doing the aggravating sport or exercise. As the tendonitis progresses, however, the soreness becomes more frequent and constantly bothers you throughout the day.

Common Symptoms of Tendonitis

 Verywell/Jessica Olah

Using Ice

If your knee is hurting, ice is an easy and accessible treatment option in many different situations. Applying ice to your knee causes blood vessels to narrow (called vasoconstriction), leading to a decrease in the amount of blood flow to the area. Because of this, icing can be helpful in relieving inflammation, decreasing swelling or bruising, and reducing soreness or pain.

Icing is especially useful following an acute knee injury (one that is less than 6 weeks old). Following a sprain, a strain, or a meniscal tear, ice to the knee can reduce inflammation and help prevent pain and swelling from developing. Icing (along with activity modification) may also keep tendonitis from progressing and reduce the soreness associated with it.

When applying ice to your joint, an ice pack, a bag of crushed ice, or even a frozen bag of vegetables can be used. Apply the cold object directly over the affected area, using a towel as a barrier if needed to make the temperature tolerable. Each icing session should last a maximum of 20 minutes. Be sure to use caution when icing if you have any sensation issues (such as diabetic neuropathy or Raynaud’s syndrome) which can impact your ability to feel the cold and lead to frostbite or skin damage.

Using Heat

Applying heat to a sore knee can also be helpful in specific circumstances. Unlike ice, heat increases the blood flow to your joint by widening (vasodilating) the blood vessels in the area. While this type of treatment is not indicated after an acute injury—where the goal is reducing the inflammation—it can be beneficial when dealing with a chronic issue.

For people with arthritis or other joint issues that have been present for longer than 6 weeks, heat can help reduce pain and soreness. It can also improve flexibility and range of motion in your knee by relaxing the surrounding muscles before you stretch or begin an activity.

When administering heat to your knee, use a heating pad that is warm, but not hot. Apply it over the affected area and keep it on for a maximum of 20 minutes or until it becomes uncomfortable. Again, individuals with sensory issues should use caution with heat so as to avoid any burning or damage to the skin.

Using Both Heat and Ice

In some situations, applying both ice and heat to your joint may be helpful. Called contrast therapy, this treatment involves alternating between icing and heating a joint. While this option has traditionally been utilized after exercise or participating in a sporting event to aid in recovery, it may be helpful for more chronic conditions (like arthritis) as well. This style of treatment can be performed using hot and cold packs or by alternately submerging the knee in hot and cold water.

While individuals who received contrast therapy subjectively reported less overall soreness and muscular fatigue, the research is still mixed. The current evidence is lacking on whether this treatment is helpful in managing the pain associated with a knee injury or in reducing your inflammation levels.

A Word From Verywell

Both ice and heat can be good initial ways to help diminish your knee pain. However, depending on the cause of your soreness, these modalities may not be the most effective treatments. If your pain is not improving, or if it is accompanied by progressive swelling, knee instability, or giving way of your leg, it is important to be seen by a physician. This is especially true if your knee pain occurs as the result of a traumatic injury or a direct blow to the joint. Failure to consult with a doctor can impact your healing and prolong the time it takes for you to return to normal activities. 

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Johns Hopkins Medicine. Knee pain and problems.

  2. Cleveland Clinic. Here’s how to choose between using ice or heat for pain. Updated December 8, 2020. 

  3. Greenhalgh O, Alexander J, Richards J, Selfe J, McCarthy C. The use of contrast therapy in soft tissue injury management and post-exercise recovery: a scoping review. Physical Therapy Reviews. 2020;0(0):1-9. doi:10.1080/10833196.2020.1850163