Heat vs ice… the big question!

There are many conflicting opinions on this topic and it can be very confusing! The main source of these differing opinions stems from the belief that ice reduces inflammation and pain, and is thus beneficial to injuries. For this reason Western Medicine frequently recommends using ice for pain and injuries. Chinese Medicine most often recommends heat. Patients often get conflicting opinions from different practitioners. Let’s take a look at why…

Ice reduces inflammation and has an analgesic effect. This means it takes down swelling and pain. This can be very helpful in an acute injury. Ice can be very relieving to a fresh swollen injury and is often the go to thing.

From a Chinese Medicine point of view there are a few instances where ice may be recommended but more often than not heat is believed to be much more beneficial to healing.

There are a few reasons why Chinese Medicine recommends heat over ice in most cases. The first reason stems from a belief that using ice for an injury interferes with our bodies natural and beneficial trauma response.

Our bodies react to trauma by inducing an inflammatory response. This reaction serves to increase the supply of fluids and white blood cells to an injured area. The inflammatory response is our body’s way of sending attention where needed. Although the resulting swelling and pain may be uncomfortable, they are a good sign that our body is doing what it should.

It may feel good at the time to put ice to an injury since ice is analgesic, however, when we do this we prevent our bodies from sending those healing fluids and blood to an area that needs those supplies for healing. This is one of the reasons why we rarely recommend using ice and only suggest it be used for short periods of time and in a few certain instances.

The second reason why Chinese Medicine rarely recommends ice is because ice and cold have a constricting effect. When we feel cold our blood vessels constrict, our muscles tighten and clench. For this reason we never recommend putting ice on a knotted muscle or a pinched nerve.

Blood flow, relaxation and healing take place in warmth. This is the basis of Chinese Medicines preference towards heat vs ice.

When to use ice

Many people think of ice as the go to thing for all injuries. In our opinion there are 3 main instances where ice is applicable.

#1 – The first day or two of an acute injury. By acute we mean something that is a totally new injury such as a broken bone, an ankle sprain, an injury from a fall, a black eye etc. This does not include an acute flare of a chronic injury such as a back that goes out from time to time, a shoulder that flares up, or a ‘bad knee’.

The main reason ice is applicable in these cases is for its analgesic effect. It is helpful for comfort and pain in severe injuries. Nonetheless, ice will restrict our bodies beneficial inflammatory response and inhibit the flow of essential fluids and extra white blood cells to these areas. For this reason we say use ice for a day or two only and if you must. If you can do without it may be better for your overall recovery.

#2 – When you need to get back in the game. Again ice here is used for its analgesic effect. Use ice if you are in the middle of an activity that must be completed. A few examples would be; knee pain in the middle of a soccer game, back pain during a long bike ride, a twisted ankle during a performance etc. In many of these cases we recommend switching to only heat after the activity is completed.

#3 – For an insect bite. Ice is great for a bee sting or wasp bite.

When to use heat

Heat should be used in ALL chronic pain situations. Chronic means something ongoing. This includes acute flares of chronic issues. This means use heat for: neck pain, back pain, a pinched nerve, hip pain, knee pain, foot pain etc etc. Basically ALWAYS use heat unless it is one of the 3 cases discussed above.

My personal favorite form of heat is a heating pad. I absolutely recommend that everyone have at least 1 heating pad at home. These can affordably be purchased online, at any CVS, Walgreens, Target, or local pharmacy.

Alternating heat and ice

Many people ask us about alternating heat and cold. The main concept of this is to alternately constrict and dilate blood vessels thus flushing and infusing an area with circulation. For the most part Chinese Medicine really recommends only heat as the best measure.