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ice or heat?

A common question: ice or heat for pain?

We often see a lot of confusion around whether to use ice or heat. Don’t worry, many physical therapists also are divided on this subject. I have a pretty clear rationale for each use so I thought i would shed my view on both uses:


With ice being a good vasoconstrictor, it means it causes the blood vessels to tighten and therefore reduce blood flow to the injured area. Often, with an acute injury or tissue damage, vasodilation and increased blood flow will also cause inflammatory mediators and fluid to pour into the area. This can actually cause secondary damage to the area and so as a rule of thumb, if you injury is acute or new, then ice will prevent fluid build up and thus secondary tissue damage.

There are also some theories that the use of ice can inhibit pain pathways to the brain. This means the sensation of pain is either inhibited or reduced resulting in less pain.

In a nutshell, ice for an acute injury is beneficial for pain reduction but also in reduction of further tissue damage. I usually recommend ice use in the first 48 – 72 hours of initial onset. Ice can be beneficial in:

  • acute neck or back pain (new onset)
  • sprains or muscle strains
  • pain after exercise or exertion

At Trigg Chiropractic we recommend using ice in the initial stages of treatment, our regime is 10 minutes on and off for 3 cycles (1 hour) followed by 10 minutes every 2 hours. Some people don’t like the sensation of ice and so in this instance, I recommend alternating heat and ice.


Heat packs are great for increasing blood flow through vasodilation, often the heat can also result in the relaxation of muscular spasm in the non acute phase. Generally i recommend that if your complaint is chronic (longer than 6 months), and you are feeling tightness as opposed to acute pain, then heat packs will be of benefit. I find heat also really helps with tension type or cervicogenic type headaches. The warmth also helps in chronic complaints such as osteo-arthritis, especially in the winter months when pain levels can increase. Conditions that heat is beneficial for is:

  • chronic neck or back pain
  • neck related headaches or dizziness
  • osteoarthritis of the back or joints
  • muscle tightness and tension

Ultimately, it’s patient preference in the end and many people prefer the use of ice over heat, and vice versa.

All our Chiropractors at Trigg Chiropractic are experienced in advising the use of ice or heat for your pain. We are located in coastal Trigg, surrounded by suburbs Scarborough, Watermans Bay and Sorrento. We are central to Carine, Duncraig and Karrinyup and have plenty of parking directly outside our clinic. You can call our practice on 9203 8313 or book online via the website:

We sell ‘Flex Ice’ flexible ice and heat packs in our clinic, along with small and large wheat packs.