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Should I Use Heat or Ice?

October 2, 2020 | Tips & Trends
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Without a doubt, this is one of the most frequently asked questions of physical therapists. They are also commonly misapplied. So in order to help explain what to use when, it is beneficial to first understand what exactly happens physiologically when you apply a hot pack or a cold pack.

Heat — A moist heating pad placed on the skin results in raising surface tissue temperature to between 104 and 113 degrees F. Once soft tissue reaches this temperature, the blood flow will increase to the heated area causing many therapeutic advantages including decreased pain and spasm.

Ice — Conversely, when a cold agent such as a cold pack is applied to an injured area, the underlying tissue temperatures are lowered and heat is removed from the body. Medically speaking, the immediate response is constriction (narrowing) of the blood vessels in the skin and reduction of blood flow thus decreasing acute inflammation and bleeding.

Application:

It is acceptable to use heat 24-48 hours after the injury. There are two kinds of superficial heat: moist and dry. Moist heat penetrates the skin and reaches the muscles, ligaments and joints. It is the moisture that penetrates and raises deeper tissue temperature. Examples include commercially manufactured electric heating pads that require you to dampen a sponge, microwavable wraps that can be moistened, or a heated wet towel. Dry heat typically elevates only superficial skin temperature. These might include non-moist electric pads or wraps and chemical thermal agents. Studies have shown that not only is moist heat more effective at reaching therapeutic levels but also is more comfortable.

Heat should be applied for 15-20 minutes maximum, checking the skin for redness or burning after the initial 5 minutes.

Ice is the preferred agent during the acute stage of inflammation (24-48 hours). There are a variety of sources that can be utilized as cold agents such as store-bought cold packs or a frozen bag of vegetables (i.e. peas conform nicely to joints). Conversely, homemade remedies like ice cubes in a plastic bag, ice soaked towels or a self-made gel-pack (freeze a self-sealing plastic bag with crushed ice and isopropyl alcohol at a 2:1 ratio) will also suffice.

Wrap any of these cold agents in a damp towel before applying on the affected area to protect the skin. Cold packs will remain at a sufficiently low temperature for 15-20 minutes. If longer treatment time is desired, then the pack should be replaced.

Heat or Ice?

Simple Questions to Ask Yourself:

• Is there swelling and pain? ICE

• Is there stiffness but no obvious swelling? HEAT

• Is this an acute injury (within first 48 hours)? ICE

• Are pain and swelling persisting (beyond the initial 48 hours period)? ICE

• Are you about to exercise? HEAT

• Are you sore from just finishing exercising? ICE

• Confused? ICE

The entire Phoenix Physical Therapy Team is committed to providing our patients with quality physical therapy, occupational therapy and speech therapy in a safe and healthy clinic environment. We continue to follow the guidance provided by the CDC, WHO and public health officials to update you as new information becomes available. Let’s work together to keep each other safe and healthy.

The safety of our patients, communities and team members remains our top priority. We know you have a choice in your care providers and appreciate your commitment to Phoenix and our qualified clinicians.

Here are the actions we have taken to keep our patients, communities and team healthy & safe:

  • Flexible scheduling allows for social distancing
  • Regular cleaning and sanitation of all clinic surfaces
  • Facemasks must be worn by all Phoenix staff and are recommended for all patients
  • Screening questionnaire and temperature checks prior to entering clinics
  • 6 feet of social distancing throughout the clinics

Keeping Our Clinics Safe

Here are some tips on how we can keep each other safe:

  • Handwashing is your best self-defense against the spread of germs. When soap and water are not available and hands are not visibly dirty, use at least a 60% alcohol-based hand sanitizer.
  • Please stay home if you are not feeling well, especially if you have a fever, are coughing or sneezing, or are experiencing shortness of breath. If a patient shows up with symptoms, the clinic team will work with them to reschedule.
  • Be vigilant. If you have traveled to any of the countries where there are outbreaks of the virus, please follow guidance from the CDC website and our Travel Guidelines.

Here are actions we are taking to keep our clinics clean and safe:

  • Equipment will be wiped down after EVERY use with antibacterial wipes/sprays
  • All surfaces that patients or staff may touch including door handles, countertops, seating, pens at sign-in, bathroom and all other common areas will be disinfected regularly
  • Treatment tables will be 6 feet apart
  • Team members will wash their hands often with soap and water for at least 20 seconds, particularly after going to the bathroom, before eating, and after blowing their nose, coughing or sneezin
  • Clinics will have hand sanitizer available at the front desk and in the treatment areas
  • Any Phoenix team members who are ill will be asked to stay home
  • We will maintain social distancing between patients in the clinic
  • Caregivers that are bringing a patient to the clinic should wait in their car or come back when the appointment has ended unless necessary (i.e. minor requiring a guardian or for assistance needs)
  • When possible, we will treat patients in private rooms to increase social distancing
  • Any patients that have underlying health issues (i.e. diabetes, respiratory problems, etc.) will be given the option to be seen during special clinic hours or can opt to be treated in a private room away from other clinicians and patients
  • All patients should be self-screening before entering the clinic. Our PCCs will perform a secondary screening during the check-in process and before patients enter the clinic including a screening questionnaire and temperature check.
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