Ice or Heat - which is best for my Injury?

Today’s blog is big 1, and it is all about a question I regularly get asked here at the Physio & Sports Injury Clinic in Rhos on Sea:

“Should I use Ice or Heat on my Injury to get it better…?”

So lets talk about Ice first.

Before you select any intervention, firstly you have to ask yourself an important question, what am I trying to achieve by putting ice on an injury?

Most people will say: “To reduce swelling”.

Technically that is NOT the correct answer😱. Research actually suggests that Ice is more likely to be just a simple analgesic (pain reliever), reducing the nerve ending sensation of pain. Ice (cold) exposure also helps you to sleep better, by slowing down your nervous system responses. If your body is slowed down you don’t use as much energy meaning your body can therefore prioritise other things - like repair/growth instead. (Is that why so many people sleep better with the window open at night?) Sleep is a massive topic (& 1 we will do a whole blog on).

Ice, as an analgesic can be administered in various forms: instant ice packs, crushed ice & water in a plastic sandwich bag, ice baths & various gels and sprays! Some work better than others of course (in my opinion the gels/sprays are the least effective).


1 main reason ice usually only reduces pain and not swelling is that ice can’t always penetrate deep enough to reach damaged tissue areas. When ice touches warm skin it will rapidly change in temperature & get warmer, weakening the effect of the cold.

Before applying any ice to an injury you must take care**. You must NOT use ice on: open wounds, frail/fragile or broken skin, poor skin sensation or circulatory conditions like Raynaud’s Disease. Always watch out for ice burns which can happen so easily if you leave ice on open skin too long without checking regularly (every few mins).

**If you are in any doubt, always seek the advice from a qualified Health Professional first before applying any ice self-treatment to an injury.

When should I use heat?

Heat is little different to ice and should not be used straight away with a fresh or flared-up injury.

The first aid rule of thumb is: Do No HARM for the first 48hrs of an injury!

H - no Heat

A - no Alcohol

R - Reduce movement / Rest up

M - no Massage

Heat makes blood vessels dilate so when you first hurt yourself the 1 thing you don’t want is more excess fluid accumilating in that area.

Once any inflammation has settled (after 3-4 days) you then want circulation to come back into your injury site gradually to get the tissue repaired. This process happens naturally with your normal circulation & movement but some extra hands-on Massage Therapy can help too.

As I said above I would recommend waiting a good 3-4 days before encouraging blood flow back to an injury area, otherwise it will HURT LIKE MAD!

Heat is better used for more older conditions (so long as they are not currently flared-up) e.g arthritis or just general stiff/tight muscles around the spine. My go-to devices are: Hot Water bottles, Wheat Bags, Warm showers/ Baths or of course lots of hands-on Massage Therapy to all areas of tightness 🤲. Don’t forget movement will also cause some heat! (So keep things moving too!)

Heat/Massage are a great way to help people relax, which often becomes a secondary problem when you are in pain. Pain makes you tense, you hold yourself rigid & the body then guards painful spots. Therefore relaxing the body makes you sleep and hopefully recover quicker!


To recap, If you hurt yourself; initially think about ice for the first few days. After that time get the injury moving again gradually & get some warmth back into that site eventually through natural means or with Physiotherapy!

Thanks for reading. 


If you or a friend is suffering with an injury right now and are not sure how to get it better, then click the link below.