Ice vs. Heat: Which Is Better for Your Pain?

When something hurts, will ice or heat make it feel better?

Before you go all in on one answer, here’s a confession: That’s a trick question.

Either option can be the best choice in certain situations. Sometimes, in fact, you might use BOTH ice and heat.

Confused? That’s understandable. That’s why we asked some of our experts to break it down so you know which way to go if you’ve got back pain, a pulled muscle, a headache or some other form of discomfort.

Ice or heat for pain?

Is your pain new or old? The answer to that question often determines whether you go ice or heat for treatment.

The frozen route is typically your better option when dealing with fresh injuries or new aches, says sports medicine physician Anne Rex, DO. That’s because the chill constricts blood vessels to numb pain, relieve inflammation and limit bruising.

“Ice wins to shut down swelling, inflammation and pain early on,” says Dr. Rex. “Heat may actually make an injury feel worse at first.”

But if you’re dealing with a lingering issue, warmth may be just what you need.

That’s because applying heat increases blood flow, relaxing tight muscles and soothing aching body parts. This can be especially helpful to improve the range of motion in a joint that isn’t moving well.

Let’s get more specific as to when ice or heat is best.

When to use ice

A trip to your freezer may be the path to relief if you’re dealing with the following situations:

• Acute injuries. Icing can limit that “owie” feeling and minimize swelling if you’ve just sprained an ankle, slammed a finger in a door or fell and bumped something hard. Bring the chill ASAP for best results, too.
• Tendinitis. Want to quiet a tendinitis flare-up after overdoing an activity? Applying ice can ease the inflammation in your tendons, the connective tissue between your muscles and bones.
• Gout flare-ups. When gout-related pain and inflammation strike individual joints, ice can calm the flare-ups while also helping numb the pain, says rheumatologist Linda Mileti, MD. (This is one arthritis issue where cold works best.)
• Headaches or migraines. Chilling out with a little cold treatment can sometimes dull a throbbing headache by reducing inflammation and slowing pain signals in the brain, says neurologist Emad Estemalik, MD.
• Fever. Some gentle cooling to your forehead or under your arms can offer relief if your body temperature soars into the triple digits, says family medicine physician Neha Vyas, MD. (But skip this treatment if your fever is giving you chills.)
• Bleeding. Icing constricts blood vessels, which can slow bleeding and allow clotting in a wound. (Combining ice with pressure brings the best results.)

Types of cold packs

So, if you’re going to chill an aching body part, what’s the best way to do it? Here are a few options to consider:

• Ice packs. A bag of crushed ice or a frozen gel pack works well on aches and pains because you can mold them around whatever hurts, says Dr. Rex. A bag of frozen veggies can work in a pinch, too. Put a cloth or paper towel under any ice pack to protect your skin from the cold.
• A DIY ice massager. If you need targeted icing, a DIY ice massager may be the solution. Just freeze water in a paper cup, peel back the top and use the exposed ice on the tender area. This is ideal for icing awkward spots like an elbow or heel.
• Cold masks or wraps. If you’re looking to soothe a headache, placing a cold mask or wrap over your forehead, eyes and temples may help, suggests Dr. Estemalik.

In general, icing for 10 to 15 minutes is usually enough. (Don’t extend past 20 minutes.)

Shorten your icing time when dealing with sensitive areas (like your groin) or small joints (such as your fingers). Use caution on areas with decreased sensation from neuropathy or Raynaud’s syndrome, too.

When to use heat

Getting toasty with treatment often helps in the following situations:

• Muscle knots. Over-exertion, stress or tension can knot your muscles in an oh-so-painful way. Heat can help loosen things up by increasing blood flow to the affected area, says Dr. Rex.
• Arthritis. Warmth (especially moist heat) can help loosen up joints stiffened by arthritis while also reducing pain. “Patients with more chronic osteoarthritis usually feel better with heat,” notes Dr. Mileti.
• Tension headaches. Ever feel so tense that your head hurts? Gentle heat can ease tight neck and shoulder muscles that can fuel tension headaches, recommends Dr. Estemalik.
• Tendinosis. Heat is best for relieving the irritation and stiffness caused by tendinosis, a chronic, long-term condition. (One caveat, though: The warmth only works after any inflammation goes away.)
• Menstrual cramps. Applying heat on your lower back or abdomen can sometimes ease menstrual cramps and the pain felt during periods, shares Ob/Gyn Marissa Levine, DO.

Types of warm compresses

Here are three effective ways to bring the heat:

• Heating pads. Plug-in or stick-on heating pads can bring targeted warmth to whatever body part needs it. But remove the heating source if the area becomes uncomfortably warm.
• Moist heat. Soaking in the warmth of a bath, shower, hot tub or whirlpool can feel soooo good. Just make sure the water isn’t too hot. Aim for a temperature between 92 and 100 degrees Fahrenheit (33 and 38 degrees Celsius).
• Heat wraps. Draping one of these scarf-life warmers around your neck can loosen tight neck and shoulder muscles, making them ideal for tension headaches.

Like with cold treatments, make sure you don’t get too much of a good thing and keep warming sessions to fewer than 20 minutes at a time.

When to use ice and heat

If you have a muscle strain or sprain, it isn’t a question of whether to use ice or heat. It’s a matter of WHEN to use each of them — because both can be part of your treatment plan if done in the right order.

It’s best to start with cold therapy if you’ve pulled a muscle doing yardwork or sprained your ankle playing basketball. As mentioned, this will work to limit inflammation and numb the pain.

Once you get the inflammation managed, switching to heat can address any muscle stiffness that sets in at the injury site.

What if neither ice nor heat helps?

But what happens if neither works to dull your pain? That’s when you want to contact a healthcare provider for an examination to get to the bottom of what’s behind your hurt.