Heat vs. Ice: Should You Use Heat or Ice for Your Pain?

Learn When to Use Heat and When to Use Ice for Your Aches and Pains

When it comes to relieving pain, you may have heard conflicting advice about heat and ice. Both have their uses in managing pain, but sometimes heat is best, sometimes ice is best, and sometimes you may get the best results by combining them.

woman icing painful knee
Odilon Dimie / Getty Images

If you're trying to figure out which one to use, it helps to know what types of pain each approach is best for.

Heat for Managing Pain

Before using heat to help with your pain, ask yourself the following questions:

  • Has your injury healed or is it fresh?
  • Are your muscles tight and tender?
  • Is the pain located in your joints or muscles?

The answers to these questions are relevant because of how heat works to relieve certain types of pain.

Heat can be an effective form of pain relief in three main circumstances:

  1. If the pain is caused by muscle tension
  2. If you need to "loosen" stiff joints
  3. When pain is chronic, due to either disease or injuries that have healed

This makes heat an appropriate choice for musculoskeletal conditions, such as:

When Not to Use Heat

In other cases, heat is not effective and may even be detrimental. These situations include:

  • New injuries, such as a sudden sprain or strain, because heat increases inflammation
  • When skin is broken or damaged

People with certain medical conditions shouldn't use heat therapy because heat can be detrimental to them or because they have an increased risk of burns. These conditions include:

Ask your healthcare provider before using heat therapy if you:

  • Are pregnant
  • Have heart disease
  • Have high blood pressure

Ice for Managing Pain

The benefits of ice therapy are that it can help reduce inflammation and lower sensitivity.

If your injury is new, ice may be the answer. It can help to decrease swelling and bleeding and can reduce bruising caused by trauma. Ice isn't only for new injuries, however: it can numb sensitive areas and decrease pain sensations caused by chronic conditions as well.

In fact, ice can be an effective pain reliever for many chronic pain conditions, including:

Some of those overlap with the ailments that can be helped by heat. If you have one of those conditions, you may benefit from either or from both at different times. It all depends on what feels best to you.

When Not to Use Ice

Ice is generally a bad choice for stiffness and old muscle aches because it has the opposite effect of heat—it can make muscles tense up.

People with certain chronic conditions should be cautious about using ice. These include:

  • Fibromyalgia
  • Trigger points
  • Myofascial pain syndrome

Ice increases pain for some (but not all) people with these conditions.

Additionally, fibromyalgia can include problems with body-temperature regulation, which can make it difficult to warm up after being exposed to cold. Ice may also be too intense for the sensitized nervous system.

In the end, though, use what works for you.

Use Heat For:
  • Muscle tension

  • Stiff joints

  • Chronic pain

Use Ice For:
  • New injuries

  • Chronic pain

Combining Ice and Heat for Pain

Many treatments for pain include the use of both heat and ice, with recommended exercise or stretching in the middle.

For certain types of pain and injuries, you can apply heat to a muscle to warm it up, stretch and strengthen it, and then finish it off with a little ice to cool it down. It's not exactly a spa treatment, but it helps many people tolerate the exercises used in therapy that will benefit them.

A Word From Verywell

If you're unsure of whether to use heat or ice on your aches and pains, consult your healthcare provider or physical therapist. Your treatment recommendation should be based on the cause and source of your pain and where you are in treatment or the healing process. Be your own advocate and educate yourself on the best approach for pain relief. 

2 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. Singh DP, Barani lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM. Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury. Front Physiol. 2017;8:93. doi:10.3389/fphys.2017.00093

  2. Dehghan M, Farahbod F. The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study. J Clin Diagn Res. 2014;8(9):LC01-4.

Additional Reading
  • Belanger, Alain-Yvan. "Evidence-Based Guide to Therapeutic Physical Agents" Philadelphia: Lippincott Williams & Wilkins 2003
  • Gould, Harry J. "Understanding Pain: What it Is, Why it Happens and How It’s Managed" New York: AAN Press 2007

By Erica Jacques
Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center.