Ice or heat?

Everyone has a firm opinion. The evidence is softer than the opinions.
Ice is usually reached for in the first day or two after a sudden strain, heat for ongoing stiffness. The research is less clear-cut than the confidence people have about it, and comfort is a reasonable guide.
Fifteen minutes
Either one, then a break. Longer is not better.
Always use a barrier
Never put ice or a heat source on bare skin.
Go with what helps
If one clearly feels better, use that one.
How long does it usually last?
Either is a short-term comfort measure, not a fix. If you are still reaching for it daily after two weeks, the underlying issue has not settled and is worth having looked at.
When should you see someone?
- Still needing ice or heat daily after two weeks
- Pain that wakes you at night
- Numbness or tingling down a leg
- Weakness in a leg or foot
- Redness, swelling, or warmth that keeps increasing
Any of these are worth an in-person evaluation rather than waiting it out.
How do you keep it from coming back?
- Use either as comfort, not as the plan
- Keep moving gently alongside it
- Fifteen minutes at a time with a barrier on the skin
- Do not use heat on a fresh swollen injury
Should I use ice or heat for back pain?
Ice is generally used in the first day or two after a sudden strain, heat for ongoing stiffness. The evidence for both is modest, so comfort is a reasonable guide.
How long should I apply ice or heat?
About fifteen minutes at a time, always with a barrier against the skin. Longer is not better.
Can I use both?
People often do, heat before movement and ice after activity that aggravated things. Neither fixes the problem on its own.
When should I stop relying on ice or heat?
If you still need it daily after two weeks, the underlying issue has not settled and is worth an in-person evaluation.
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