Ice vs. Heat After Injury: What’s Best for Your Recovery?

May 23rd, 2025

When recovering from an injury, one of the most common questions is: Should I use ice or heat? Both methods can be effective—but knowing when to use each can make a big difference in your recovery.

What is Inflammation?

OrthoCarolina PA Kristi Wheeler describes inflammation as the body’s natural reaction to an injury. As much as it might hurt, swollen and inflamed tissue contains the components of healing that your body uses to repair itself after an injury.

“When an area on your body is inflamed, fluid (“water on a joint”) and/or irritation cause pressure in the area. It’s this pressure that causes you to feel pain,” Wheeler explains.

Depending on the nature and severity of the injury, in orthopedics, we treat inflammation using a combination of anti-inflammatory medication, elevation of injury, massage, cortisone injections, compression and rest.

When to Use Ice:

Use ice for new, acute injuries—especially within the first 48-72 hours.
Ice constricts, or narrows, blood vessels. Constricting blood vessels inhibits the body from allowing inflammation in the iced area. Heat dilates, or widens blood vessels, allowing more inflammation to flow to an injured or painful area.

This makes ice ideal for:

• Sprains and strains
• Bruises or contusions
• Joint injuries (like an ankle sprain or knee twist)
• Post-surgical swelling (as directed by your physician)
• Apply ice immediately after practice, a game, or injury to reduce swelling and speed up recovery.

How to apply ice:

As a general rule of thumb, ice should be used if you have recently injured an area or had surgery or a procedure. Be sure to put a thin towel between the ice and skin to avoid burned skin.

• Use an ice pack or a bag of frozen peas wrapped in a towel
• Apply for 15-20 minutes at a time, with 30 minutes to 1 hour between sessions

“Although many articles and studies may say that heat should be used for injuries and pain that have lingered for longer than six weeks, this is not always the case,” Wheeler explains. “For conditions such as chronic tendonitis and osteoarthritis, the body thinks that it can heal the worn or injured area. The body continues to go through a cycle of increased inflammation even though it cannot heal these conditions on its own.”

Studies show icing for 20 minutes several times a day can work as well as, if not better than, oral medications and injections. By controlling inflammation, symptoms often resolve or improve and pain subsides.

When to Use Heat

Heat does have its role. Heat works best in larger muscle groups. As an example, heat helps to ease back muscle spasms – as long as the spasms are not caused by a new fall or injury.

Use heat for chronic pain or stiffness—not fresh injuries.

Heat helps relax muscles, improve circulation, and ease tension. It’s best for:

• Muscle soreness or tightness
• Chronic back or neck pain
• Large muscle groups like quads, hamstrings and calves will respond well to heat after three days of injury
• Old injuries that no longer have swelling

How to apply heat:

• Use a heating pad, warm towel, or hot water bottle
• Apply for 15-20 minutes at a time, with 30-40 minutes rest between heat
• Avoid heat if the area is swollen, bruised, or warm to the touch

Important Tips

• Avoid heat on new injuries—it can make swelling worse.
• Avoid ice before activity if it numbs the area too much and limits movement.
• If in doubt, start with ice. You can always switch to heat after a few days if the swelling has gone down and stiffness sets in.

When to See an Orthopedic Specialist

If pain, swelling, or stiffness lasts more than a few days, or if you’re unsure which treatment is best, it’s time to consult a specialist. From athletes to weekend warriors, OrthoCarolina’s partnership with the HURT! App is a great resource to get immediate feedback about your injury.

From surgical procedures to recovery protocols, OCRI’s research is always focused on helping you heal so you can get back to the activities you love most.