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Depending on your condition, you may receive a cold or hot pack prior to treatment. Ice will decrease pain and inflammation for new (acute) injuries. For more chronic injuries, heat will help your body relax allowing for an easier adjustment.

Heat and ice have been used for many years to treat pain and to reduce swelling, and many people have found them effective. More recently, studies have been done to investigate whether heat and ice really make a difference to healing and the results have been inconclusive. In general, when used sensibly, they are safe treatments which make people feel better and have some effect on pain levels and there are few harms associated with their use.


Heat is an effective and safe treatment for most aches and pains. Heat causes the blood vessels to open wide (dilate). This brings more blood into the area to stimulate healing of damaged tissues. It has a direct soothing effect and helps to relieve pain and spasm. It can also ease stiffness by making the tissues suppler.

Heat should not be used on a new injury. It will increase bleeding under the skin around the injured area and may make the problem worse. The exception to this is new-onset low back strains. A lot of the pain in this case is caused by muscle spasm rather than tissue damage, so heat is often helpful. A large-scale study suggested that heat treatment had a small helpful effect on how long pain and other symptoms go on for in short-term back pain. This effect was greater when heat treatment was combined with exercise.

Heat is often helpful for the following types of pain:

  • Aching Muscles from Over-Exertion
  • Aching Pains from Fibromyalgia and Other Chronic Pain Conditions
  • Cramping or Spasm Pains such as Period Pains


Ice has traditionally been used to treat soft tissue injuries where there is swelling. However, there is a growing body of evidence which suggests that applying ice packs to most injuries does not contribute to recovery and may even prolong recovery. This is related to the fact that reducing the temperature at the site of an injury will delay the body’s immune system response. It is the action of the immune system which will heal the injury.

In one study, some people who used ice said that it was helpful for managing pain, although this did not translate into a lower use of painkillers. Many people find that ice is helpful when used to manage pain in the short term. It is unlikely that it will have much of a negative effect in the long term when used in this way.With any sprain, strain or bruise there is some bleeding into the underlying tissues. This causes swelling and pain. Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation.

During immediate treatment, the aim is to limit the body’s response to injury. Ice will:

  • Reduce Bleeding into the Tissues.
  • Prevent or Reduce Swelling (Inflammation)
  • Reduce Muscle Pain and Spasm.
  • Reduce Pain by Numbing the Area and by Limiting the Effects of Swelling

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