What Ice and Heat are for

What ice and heat are for

Ice is for injuries, and heat is for muscles.

Ice is for injuries — calming down damaged tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process … that also happens to be incredibly painful and persistent. Icing is mostly just a mild, drugless way of controlling the pain of inflammation. Examples: a new case of IT band syndrome or a freshly pulled muscle.

Heat is for muscles, chronic pain, and stress — taking the edge off the pain of whole muscle spasms and trigger points, or conditions that are often dominated by them, like back and neck pain), for soothing the nervous system and the mind (stress can be a major factor in many chronic pain problems).

What ice and heat are not for

Heat can make inflammation worse, and ice can make muscle spasms worse, so they have the potential to do some mild harm when mixed up. And both are either pointless or harmful when unwanted: icing when you already feel shivering, or heating when your already sweating. The brain may interpret an excess of either one as a threat — and when brains think there’s a threat, they may also amp up the pain.

But heat and inflammation are a particularly bad combination. If you add heat to an fresh injury, watch out: it’s going to get worse! A physician once told my father to heat a freshly injured knee, and wow — it swelled up like a balloon, three times bigger than it had been before. And three times more painful. (That is a rare example of a particularly severe negative reaction to heat. Most cases are not going to be that bad!)

The lesser known threat is from icing at the wrong time, or when it’s unwanted.

If you ice painful muscles, watch out: it’s probably going to get worse! Ice can aggravate muscle spasms and trigger points, which are often present in low back and neck pain — the very condition people often try to treat with ice. Severe spasm and trigger points can be spectacularly painful, like knife wounds, and are easily mistaken for “iceable” injury and inflammation. But if you ice these tissues, woe is you — the muscles are likely to contract even harder, and the trigger points burn and ache even more acutely. This mistake is made particularly often with low back pain and neck pain.