Ice packs and heating pads are among the most commonly used treatments in orthopedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last? Read on for information about treatment of injuries with ice packs and heating pads.
Ice Treatment
Ice treatment is most commonly used for acute injuries. If you have had a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice. Ice packs can help minimize swelling around the injury, reduce bleeding into the tissues, and reduce muscle spasm and pain.
Ice packs are often used after injuries like ankle sprains have occurred. Applying an ice pack early and often for the first 48 hours will help minimize swelling, and decreasing swelling around an injury will help to control the pain. Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity.
You can make ice packs with ice cubes in a plastic bag or wet tea towel; a pack of frozen peas is also ideal and can go in and out of the freezer. Never place ice directly on an injury; keep the pack moving to avoid ice burns. Never treat with ice for more than 30 minutes, and remove the pack immediately if the injury appears bright pink or red.
Don’t use ice packs on the left shoulder if you have a heart condition, and don’t use ice packs around the front or side of the neck.
Heat Treatment
Heat treatments should be used for chronic conditions to help relax and loosen tissues and to stimulate blood flow to the area. Use heat treatments for conditions such as overuse injuries before participating in activities.
Do not use heat treatments after activity, and do not use heat after an acute injury. Never use heat where swelling is involved because swelling is caused by bleeding in the tissue, and heat just draws more blood to the area.
Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping.
Other Precautions
Don’t use cold or heat packs:
• over areas of skin that are in poor condition • over areas of skin with poor sensation to heat or cold • over areas of the body with known poor circulation • if you have diabetes
• in the presence of infection
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Treatment for a sports injury will depend on factors such as how severe the injury is and the part of your body affected.
Information and advice about treatments for specific injuries:
Some general treatments that may be helpful for your injury include:
Minor injuries, such as mild sprains and strains, can often be initially treated at home using PRICE therapy for two or three days.
PRICE stands for protection, rest, ice, compression and elevation.
- Protection – protect the affected area from further injury – for example, by using a support.
- Rest – avoid exercise and reduce your daily physical activity. Using crutches or a walking stick may help if you can't put weight on your ankle or knee. A sling may help if you've injured your shoulder.
- Ice – apply an ice pack to the affected area for 15-20 minutes every two to three hours. A bag of frozen peas, or similar, will work well. Wrap the ice pack in a towel so that it doesn't directly touch your skin and cause an ice burn.
- Compression – use elastic compression bandages during the day to limit swelling.
- Elevation – keep the injured body part raised above the level of your heart whenever possible. This may also help reduce swelling.
Painkillers, such as paracetamol, can be used to help ease the pain.
Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) tablets or creams can also be used to ease pain and reduce any swelling.
Aspirin shouldn't be given to children under 16 years old.
Immobilisation can sometimes help prevent further damage by reducing movement. It can also reduce pain, muscle swelling and muscle spasm.
For example, slings, splints and casts may be used to immobilise injured arms, shoulders, wrists and legs while you heal.
If you have a sprain, prolonged immobilisation isn't usually necessary, and you should try gently moving the affected joint as soon as you're able to do so without experiencing significant pain.
Some people recovering from a long-term injury may benefit from physiotherapy.
It's a specialist treatment where techniques such as massage, manipulation and exercises are used to improve range of motion, strengthen the surrounding muscles, and return the normal function of the injured area.
A physiotherapist can also develop an exercise programme to help strengthen the affected body part and reduce the risk of the injury recurring.
A corticosteroid injection may be recommended if you have severe or persistent inflammation.
It can help relieve pain caused by your injury, although for some people the pain relief is minimal or only lasts for a short period of time.
If necessary, a corticosteroid injection can be repeated, but you'll usually only be able to have two or three injections a year.
Side effects can include thinning of the skin, loss of fat, and infection. The doctor treating you will be able to explain the possible side effects in more detail.
Most sports injuries don't require surgery, but very severe injuries such as badly broken bones may require corrective treatment. This may include a manipulation or surgery to fix the bones with wires, plates, screws or rods.
In some cases, it may be possible to realign displaced bones without needing an operation.
Certain other injuries may also occasionally require surgery. For example, an operation may be needed to repair a torn knee ligament.
Read more about knee ligament surgery.
Depending on the type of injury you have, it can take a few weeks to a few months or more to make a full recovery.
You shouldn't return to your previous level of activity until you've fully recovered, but you should aim to gently start moving the injured body part as soon as possible.
Gentle exercises should help to improve the area’s range of movement. As movement becomes easier and the pain decreases, stretching and strengthening exercises can be introduced.
Make sure you don't try to do too much too quickly because this can delay recovery. Start by doing frequent repetitions of a few simple exercises before gradually increasing the amount you do.
In some cases, the help of a professional, such as a physiotherapist or sports injury specialist, may be beneficial. They can design a suitable recovery programme and advise you about the exercises you should do and the number of repetitions.
Page last reviewed: 31 March 2020
Next review due: 31 March 2023
Benefits
Ice can decrease swelling and inflammation and help stop bleeding. The cold restricts blood circulation, which in turn can numb the pain. It can also help limit any bruising.
You can keep instant cold packs in your home first-aid kit or in your car in case of emergencies. Instant cold packs have chemicals that activate when you squeeze the pack.
You can also make cold compresses with materials found right your own home. Even if you don’t like ice in your drinks, keeping extra ice in the freezer can be a good idea. That’s because ice can help you make a cold compress quickly, easily, and affordably.
Read on to learn everything about when to use a cold compress, how to make one, and for how long to use it.
To make your own cold compress, you’ll need:
- ice (or frozen vegetables)
- washcloth
- water
- plastic bag
- towel
Step 1: Place ice cubes in a plastic bag. You can also substitute ice with a bag of frozen food. It’s best to use smaller vegetables so the bag will sit well on your skin. If you do need to use a bag of frozen food, fill up ice cube trays in the meantime. That way, you have a backup when the bag of frozen food thaws out.
You can also use a towel to make a cold compress if you don’t have ice:
- Dampen a towel with cold water and place it in a sealable plastic bag.
- Put the bag in the freezer for 15 minutes.
Cold compresses made from wet towels may be more comfortable for sensitive areas, such as the eyes.
Step 2: Run a washcloth under cold water and then wrap it around the plastic bag of ice. You can also dip the wash cloth into an ice bath if you don’t think it’s too cold against your skin.
Step 3: Place the homemade compress on your skin for up to 20 minutes.
Step 4: Dry the area with a towel after you’re done. You can also dab the skin as you hold the ice pack on yourself. The ice may start melting pretty quickly.
Reapply: For swelling, reapply the compress after two hours. Keep doing this until the swelling goes away.
It helps to ice the injury within the first 48 hours. Immediate treatment is better.
Avoid using cold compresses for more than 20 minutes at a time. It’s best to alternate between 20 minutes on and 20 minutes off. You can keep icing for days if needed. There is no set amount of time in which you need to stop. However, consider making an appointment with the doctor if you don’t see improvement within 48 to 72 hours.
Also, be sure to follow the other steps in the RICE system if you have an injury:
You can place a cold compress anywhere on your body, including your eyes, lower back, forehead, and more. Injuries that aren’t life-threatening can often benefit from a cold compress. Ice can help relieve the pain from:
Cold compresses can be used on both adults and children. Be careful when using ice packs on babies, though. They may not be able to tolerate such cold temperatures. You may want to run a wash cloth under cold water and use that instead.
Read more: Sprains vs. strains »
Using cold compresses is one of the easiest ways to treat an injury. Still, there can be unintended side effects if you don’t do use the compress properly.
For long-term injuries like arthritis, chronic irritations, and constant stiffness of the joints, it’s best to use heat. Keep the “six week rule” in mind: For any injury that has lasted for more than six weeks, stick with heat to increase blood flow.
Everyone faces injuries and muscles aches from time to time. Putting together a cold compress takes mere minutes and can often provide instant relief. You can make a compress from household items, including ice, bagged frozen vegetables, or even a frozen towel. It’s also a good idea to keep cold packs in your first-aid kit in case of emergencies.
Keep reading: Treating pain with heat and cold »