Has a weekend squash session left you sore and stiff? Or did you miss a step on the stairs and crash on your knee? In either case, what would you reach for first—an ice pack or a heating pad?

Applying cold or heat for minimal injuries has been used for centuries, and rightly so. But not many know which one is suitable for what kind of pain.

Hot Or Cold?
According to Dr Kaixuan Liu, a nationally distinguished leader in endoscopic spine surgery and chief surgeon at Atlantic Spinal Care in Edison, New Jersey, “Both heat and cold can work efficiently to reduce pain and swelling, although they have to be used correctly, since picking the wrong remedy can actually make the pain worse and potentially delay the healing process.”

Before you start loading up on ice packs, hot water bottles or heating pads, it is important to understand the reason behind your pain. Now one may argue why this is so important. Why does it matter what’s causing the pain? “It’s all about inflammation”, says Dr Liu. Most acute injuries are caused by something mechanical (trauma) and an inflammation is the body’s response to counteract this injury. It involves an influx of blood, immune cells and other healing chemicals to get rid of any invading agents and kick start the healing process. “Inflammation is the body’s way of protecting itself, but results in swelling which causes the pain”, explains Dr Liu.

Ice For Your Pain
Dr Liu recommends applying ice for acute or fresh injuries that are usually more painful and often associated with redness and swelling. Since much of the inflammation and swelling are a result of ruptured capillaries in the area, a colder temperature can constrict the blood vessels, thus preventing further leakage of blood and serum which can reduce the pain and swelling. Dr Liu adds, “Colder temperatures can slow down the nerve impulses, thus interrupting the transmission of pain messages to the brain and numbing the area, much like a local anesthetic.”

A word of caution before using ice to relieve your pain:

  • Only use ice for topical application and not for more than 20 minutes at one stretch.
  • Always remember to wrap ice packs in a towel or plastic bag before applying to the affected area.
  • Do not use ice packs for more than four to six applications during the day.

Best Used For: Gout flares, sprains, tendinitis.

Heat For Your Pain
Heat is relaxing and that is the reason stiff and sore muscles respond best to heat. “Heat dilates the blood vessels in the area to increase the flow of blood, which carries oxygen and other nutrients to the muscles to help damaged tissues heal. Heat also relaxes muscles, reduces painful spasms and cuts down on stiffness,” explains Dr Liu. However, he quickly cautions that applying heat to an already inflamed area can make the swelling worse and cause more pain. Be careful while using heat sources and always fold it in a towel to prevent burns, he says.

Best Used For: Chronic back pain, arthritis, strains, menstrual cramps

The fact is that both these therapies can relieve a wide range of aches and pains. However, it is best to talk to your doctor or physician in case you wish to use a combination of cold and heat therapy simultaneously. As they say, “Timing is everything!”

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