I am often asked the question about heat vs ice. First let me say that there is a lot of mythology about this question. My opinion is simply based on the science.In the clinic, I answer the question this way:

Heat works to reduce pain through a cutaneous (skin) reflex that is inhibitory to pain as long as the receptor is being stimulated.  The problem is that the receptor accommodates to the heat and so the heat source has to get hotter and hotter in order to inhibit pain.  One risk in using heat to treat pain is the possibility of a deep second or even third degree burn.

Ice on the other hand, actually produces anesthesia after it has been on for a time. Ice reduces swelling, and ice causes muscle guarding to cease. Ice also lasts for long after the ice has been taken off, whereas heat stops working as soon as it is removed from the skin.

The secret to the safe use of ice is that you need to combine ice and water to ensure that the temperature stays at O degrees Celsius. Ice plus water in a plastic bag on the skin for a half hour will numb the muscles of the back, reduce pain for up to two hours and will reduce swelling. You can ice every two hours for half an hour.

Ice is your friend, but make sure that you use ice plus water so that your don’t get freezer burn.