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Heat or Cold: Which is the best to treat pain?

Ice packs and heating pads are both commonly used to treat pain, but sometimes it can be confusing to know which one to use, which one is safer and whether one can aggravate the injury.

Cold pack on shoulder

Heat Therapy: Use for chronic pain or stiffness

Heat therapy opens blood vessels, which increases blood flow, cuts down pain and relaxes muscles. It is perfect for stiffness or ongoing pain. Heat can be applied to an injury with an electric heating pad, hot water bottle, gel packs heated in water or microwaves, or hot water baths. When applying heat therapy, please adhere to the following safety tips:

  • Use moderate heat. Never use boiling or scalding water.

  • Check skin every 5 minutes to make sure it is not too hot.

  • Do not apply heat directly to the skin.

  • Do not use heat if you have no feeling in the affected body part or poor circulation.

  • Do not use heat on damaged skin or stitches.

  • Do not use heat if there is swelling.

  • Do not use heat on damaged skin or stitches.

  • Do not use heat for extended periods of time or while sleeping.

Cold Therapy: Use for immediate injuries, sprains and strains

Cold therapy slows down the blood flow to an injury, which cuts down the swelling and pain. Any cold treatment should be used right after injury. Cold therapy can be an ice pack, gel pack or cold water from the facet. Cold therapy is good for bumps, sprains and strains that may occur with sports of lifting. Also, cold therapy is good for nosebleeds. Ice can be wrapped in a washcloth and placed over the nose while the head is kept upright. Lastly, cold is beneficial for minor burns by applying cold water from the faucet immediately following the injury. Please adhere to the following safety tips, when applying cold therapy:

  • Do not place ice directly on the skin.

  • Treatment should not last more than 20 minutes.

  • During treatment, check skin every 5 minutes to make sure there is no damage, such as a freeze burn (skin would become red-densed or blistered, just as when burned with heat).

  • Wait 1 hour between cold treatments.

If you're unsure of whether to use heat or ice on your aches and pains, consult Cardinal Physical Therapy, your partner in physical therapy care at 440.688.4186 or at


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