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  • Writer's pictureDr. Jill King

Should I Use Heat or Ice?

Updated: Jul 7, 2021



There is much debate, and confusion, on when to use ice, and when to use heat to treat neck pain and stiffness. It is important to know because therapeutic icing and heating (cryotherapy and thermotherapy) are effective, cheap, and safe self-treatment options.


How Does Ice Work?


Ice has long been thought of as nature’s natural pain killer. It has powerful effects on the human body when applied to the skin, some of which we have only recently begun to understand.

Ice has been used for many years as a form of pain relief, and there are accounts of ice being used to treat injuries in the earliest days of mankind.


Ice works through a couple of mechanisms:

  • Ice, when applied to the skin, produces an effect called “vasoconstriction” in the blood vessels – which basically means the small vessels narrow and shut down blood flow to that area. That’s one of the reasons ice is so useful for swelling, such as after an ankle sprain.

  • Ice also has an effect on the nerves around the area, dampening their signals which means we feel naturally less pain with an injury.

  • Ice also encourages flushing out of the potentially harmful chemicals around an injury site and reduces inflammation.

How Does Heat Work?

When we say heat, what we mean usually is a warm compress, hot water bottle, or heated rice pad applied to an area of skin around an injury. You could also get these effects from a hot bath or shower, but this would be a less “targeted” way of treating an area.


Heat works roughly in the opposite way that ice works. It, too, has a number of effects on the body when applied around an injury:

  • Heat causes an effect called “vasodilation” to the blood vessels around an area – which means a widening of the vessels, increasing blood flow to an injured site. You wouldn’t want to use heat on a recently sprained ankle (unless you wanted a HUGE amount of uncomfortable swelling!)

  • Heat doesn’t affect the nerves like ice does, but it does increase healthy blood flow to an area, which can cause an increased rate of healing to some injuries (especially chronic, long-term ones). It also helps to flush away the nasties within the blood that invade an injured area.

  • Heat has an effect on the surrounding muscles and joints whereby it “loosens” them up by making the tissues more “elastic” and pliable. This basically means you can increase the flexibility of an area just by heating it up. Try to stretch a muscle in the cold, then try to stretch the same muscle after a hot shower – you’ll find you can stretch way further after the hot treatment.


Heat is often best for:

  • Arthritis

  • Headaches caused by neck spasms

  • Muscle spasms

  • Tendinosis

  • Relieving stiffness of strains and sprains after inflammation has resolved

Ice is best for:

  • New injuries

  • Strains and sprains

  • Sports injuries

  • Throbbing headaches

  • Gout flare-ups

  • Tendinitis (commonly in the shoulder, elbow, knee, and wrist)


Ice and heat are both phenomenal tools that are easily applied to help recovery from an injury. Although there can be confusion about when to use ice and when to use heat, use the handy guide above for best results. At the end of the day, a lot of it will come down to personal preference, so if you aren’t getting the desired effect with ice, try heat and vice versa. If at-home heat or ice therapy isn’t improving your condition, give us a call. We’ll get you in for a visit to see if we can help.

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