When to Use Cold or Heat Therapy for Pain, Stiff Muscles and Joints

When to Use Cold or Heat Therapy for Pain, Stiff Muscles and Joints


Heat and cold therapies are very common types of home treatments to relieve pain, but have you ever wondered whether you should use heat or cold therapy when suffering from sore muscle, injury or joint pain? In this article I will explain the purpose of heat and cold therapies, and when to apply each one of them.

What is Heat Therapy?

The aim of heat therapy (thermotherapy) is to increase blood flow and supply oxygen and nutrients to the area where it is applied.

The heat also decreases joint pain, soothes sore muscles and muscle spasm, increases limited motion and flexibility of tendons and ligaments.

When our muscles are overworked and are put under stress, they are deprived of oxygen and can become sore due to accumulation of lactic acid. Lactic acid build-up creates muscle ache, and in this case heat therapy can help to stimulate blood flow and help in removing the lactic acid from the muscles.

The Different Types of Heat Therapy

Heat therapy can be dry or moist, and can be applied locally to a specific area in the body. For example you can use a heating pad, warm compress, damp towel or hot water bottle to apply heat locally.

In this case the heat source should be warm, but not too hot, and should be maintained at a consistent temperature. You also need to protect your skin from direct contact with the heat source to prevent burns and wrap the heat source with a towel.

It is also advised to apply heat therapy for no more than 20 minutes, unless your doctor or physiotherapist recommends otherwise.


Heat therapy can also be systematic, which means that it doesn’t applied locally to the affected area, but to the whole body. Systematic heat therapy increases the whole body temperature. For example, you can use sauna or hot shower and bath as systematic heat therapy. Make sure to stay hydrated and avoid prolonged exposure when using systematic heat therapy.

When to Apply Heat Therapy

The basic rule is that heat is best for treating chronic muscle and joint pain and stiffness or an injury that is a day or more old. As an example, you can use heat in chronic conditions such as back pain, neck pain and arthritis.

What is Cold Therapy?

Cold therapy should be applied locally to the affected area, ideally within 5-10 minutes of injury.

When the body is injured, the affected tissues become inflamed, and this can cause pain and swelling.

The aim of cold therapy (cryotherapy) is to numb the affected area and slow down blood flow, thus relieving pain, reducing swelling, inflammation and bleeding.


The Different Types of Cold Therapy

You can apply cold using a cold gel pack, a bag of frozen vegetables, or ice towel which you can make by damping a folded towel that has been sealed in plastic bag and placed in the freezer for about 15 minutes.

Some doctors recommend using a bag of frozen vegetables because the frozen vegetables can easily conform to the injured body part shape.

When using an ice pack, avoid excessive use of cold which can cause tissue damage. Always wrap it in a towel before applying it to the affected area and don’t apply it for more than 20 minutes at a time. You can apply the ice pack later on after giving your body a break.

When to Apply Cold Therapy?

  • Cold therapy is used immediately after injury for acute pain or a new and recent swollen and inflamed injury.
  • A cold treatment should be used for 24 to 48 hours after an injury and is good for sprains, strains, and bruises.
  • Do not use cold therapy on stiff muscles or joints.

Always remember – you need to choose what works best for you and take into account the type of injury.

If you are in doubt as to what therapy applies to a certain injury, call your doctor’s office.

If you suffer from diabetes, ask your doctor before using a heating pad or a cold pack. Many diabetics have peripheral neuropathy which causes feelings of numbness, usually in the hands and feet, but can also include arms and legs. In this case the person may not be able to feel if something is too hot, or too cold on his body, and the excess of heat or cold can cause tissue damage.


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