Hot or Cold? – Which works best?

Hot and cold therapy for injury.

By Hannah E. Whitcombe

You may be familiar with people using ice packs in the event of an injury, especially in the sporting arena, where, following an injury, we commonly use the acronym RICE which stands for Rest, Ice, Compression & Elevation, but when is it advisable to use ice & when is it better to use heat?

Hot And Cold Therapy For Injury
As a general rule of thumb;

  • cold therapy is better for acute pain or recent injury, where swelling and inflammation are apparent, usually advised during the first 24 hours.
  • heat therapy is better used for injury that is more than a day old or muscle aches and pains caused by postural strain. 

However, it is important to find what works for you! Everybody is different and what works for one may be totally different for another.


By applying ice to an area, you are actively encouraging constriction of the blood vessels, which helps to reduce inflammation, thus reducing pain as a result. In addition, it works by numbing the area and making you feel more comfortable.

This may be suggested as a ‘first aid’ approach in the event of an injury. Further, it may be suggested following your osteopathic session, as often symptoms can be aggravated initially during your course of treatment.

What to use

  • Frozen peas
  • Ice pack
  • Cold gel pack
  • Iced or cold towel
  • Cooling gel from the pharmacy

Please note, that it is best to cover a frozen item in a thin towel, to avoid damage or discomfort to the skin.

How long?  

2-10 minutes, as tolerated.

How often?

3-5 times per day in the first 24 hours


Heat actively encourages blood flow to the area, stimulating the body’s own healing mechanism.Great for conditions that are  longer than a day old. Also great for muscle aches and pains caused by postural strain, commonly seen in office workers.   

What to use

  • Hot water bottle
  • Heat back
  • Wheat bag
  • Heat patch
  • Heat therapy gel from the pharmacy

Please cover water bottles with material to avoid damage to the skin.

How long?

5-10 minutes

How often?

At least twice per day, but can be used as frequently as desired.


In chronic injury (injuries lasting longer than 6 weeks), it may be best to use a combination of the two, often described as contrast bathing. This will help by working on the blood flow to the area, and kick starting a healing process that may have reached a plateau.

How long?

We recommend three cycles as follows;

3 minutes of heat
1 minute of cold

In contrast bathing, it is important to always finish with an application of cold to avoid excessive dilation of the blood vessels.

How often?

At least twice per day, but can be used as frequently as desired.



If you’d like to speak with a member of our team, please don’t hesitate to get in touch. Or, if you prefer, you can book a FREE consultation with us by clicking here.


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