Is Ice Or Heat Best For Musculoskeletal Injury?

Treatment for musculoskeletal injuries typically is rendered according to the basic mnemonic RICE.

• Rest


• Ice


• Compression


• Elevation

The question is for a musculoskeletal injury, is ice better than heat? There is no hard and fast answer, as research has been unclear for a definitive answer.

The thinking is as follows. For an acute injury, such as an ankle or low back sprain/strain, ice is better. An injury sparks up increased blood flow to the area, which brings in inflammatory mediators and increases swelling. Ice can slow down the blood flow, and along with the elevation minimize the resultant swelling and pain. Ice can also provide a bit of a numbing effect for pain control. Ice treatment is also called cryotherapy.

Be careful not to apply ice continuously, as it can damage the skin. A good rule of thumb is 20 minutes on, 20 minutes off and to place a towel on top of the skin to prevent direct contact.

After the initial 48 to 72 hours of injury treatment with ice, the current recommendation is to switch over to heat. One of the first phases of healing is the inflammatory phase, for which adequate blood flow is necessary to bring in those substances.

Plenty of medical providers recommend at that point alternating ice and heat for both pain control and assisting in the healing process. After physical therapy, ice is recommended to prevent significant inflammation and throbbing along with pain. After a few hours, for instance when going to bed later on, heat may assist with relaxing the affected body part and allow one to fall asleep easier.

This is the current thought process for ice and heat treatment with a musculoskeletal injury. When used in conjunction with physical therapy and possibly chiropractic treatment, ice and heat can be very effective modalities.