The question of whether to apply ice or heat to a particular injury is a familiar one for many people—and especially for parents who see more than their fair share of kids’ cuts, bumps and bruises. We know we want to relieve the pain, reduce swelling and speed healing, but which is the right approach, ice or heat? And how can you tell?

Both heat and cold can be beneficial in certain circumstances, but each can also cause more harm than good if applied at the wrong time or in the wrong way. This article provides several simple guidelines that you can use to help decide on the best course of treatment.

The first general rule is to ice an acute injury and apply heat to a chronic injury. Swelling (aka inflammation) is your body’s natural first response to injury—your blood vessels expand in order to rush more blood to the area to begin the healing process. So the best thing to do within the first 24 hours of an acute injury is to apply ice. This will cause blood vessels to contract, reducing inflammation and bringing down the swelling. It will also relieve the pain by numbing the area.

Ice or cold packs should never be applied directly to the skin, since this can actually cause damage to the tissue. Instead, they should be wrapped in a damp washcloth or towel. An even simpler approach is to use a bag of frozen peas. Ice should be applied to the injury for 10 to 20 minutes every two hours within the first 72 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours unless it is being used to aid recovery after a strenuous athletic workout.

Heat treatment is typically most useful for chronic injuries since it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat can also reduce joint stiffness and muscle spasms. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. While sitting in a hot tub may feel good in the moment, it may trigger more pain and stiffness the day after.

Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm (rather than hot) treatments should be used to avoid the risk of burns, and heat should never be applied over an extended period of time or while you are sleeping.

Chiropractic physicians are experts in diagnosing and treating a wide range of health conditions that affect the musculoskeletal and nervous systems. We also understand that effective self-care can make a big difference in how completely and how quickly our patients heal. If you or someone you care about has recently suffered an injury—whether in an auto, work or sports accident—we can help relieve their pain and speed their recovery. Call or visit our office today. We’re here to help!