Often when someone gets injured or feels pain, they wonder whether to treat it with cold or heat.

Today’s medical information comes from Elizabeth Matzkin, MD, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and recently appointed Team Physician for Stonehill College Athletics, and Kaitlyn Whitlock, PA-C, physician assistant in the Women’s Sports Medicine Program.

Often when someone gets injured or feels pain, they wonder whether to treat it with cold or heat. Below are a few simple guidelines to help you determine which approach to take.

What should you do if you get injured from a fall or collide with something/someone?

The answer is ICE. Injuries that occur after a twist, fall, or collision may produce localized swelling and bleeding. Treating the affected area(s) immediately with ice will work as a vasoconstrictor (narrowing blood vessels), limiting the amount of bleeding and decreasing inflammation. Decreasing inflammation also will decrease pain. Heat, on the other hand will expand the blood vessels, causing more bleeding and pain.

What if there was no specific injury? 

If, for example, you are experiencing worsening shoulder or knee pain, the answer is still ICE. Overuse, poor biomechanics (not using your muscles correctly or poor posture), arthritis, or anatomical variations (the way the bones line up) often cause inflammation. Ice will decrease this inflammation and should be applied daily or when sore.

In general, ice is preferred over heat for most pain and immediate injuries. When using ice to treat a part of your body, it is important to not apply it directly to the skin. Direct contact can damage your skin, and in more extreme cases, it may also damage underlying nerves. Place a towel or cloth between the ice and skin. Also, ice should be applied for only fifteen to twenty minutes at any given time.

When should I use heat?

Applying heat is a good option for tight or stiff muscles, especially before exercise. This will increase blood flow to the muscles, making exercise more tolerable. After exercise, apply ice. As with using ice, do not apply heat directly to the skin. Place a towel or cloth between the heat pack and skin to prevent burns. NEVER go to sleep with a heat pack applied.

*Some injuries are more serious than others. If your pain is unbearable or not improving within a couple of days, see your health care provider.

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