It’s a question practitioners are often asked – should I use ice or heat on an injury?  Although there is no simple answer to this, with opinion still somewhat divided, here is what we advise at the clinic. In our experience, following these protocols yield the best results.



Applying ice to an area will reduce the inflammation, which in turn reduces both the swelling and the pain.  The application of ice only to the injured area should generally be in the ‘acute’ phase of injury – i.e. up to 72 hours after the injury occurred.  An ‘ice pack’ can be a specialist ‘gel pack’ kept in the freezer, or just a bag of frozen peas! Just make sure that whichever ice pack you use is wrapped up in a tea-towel or similar cloth to avoid the ice burning the skin. Also, ensure that ice is applied for no longer than 10 minutes at a time (and no more than hourly in frequency). If ice is kept on for longer it will start to have a negative effect.



Heat should not really be used on an injured area for the first 72 hours post injury.  Applying heat to an area will dilate the blood vessels which is likely to make the effects of inflammation worse.  After 72 hours – applying heat to an area can help with the healing process as opening up the blood vessels will allow the nutrients to leak out into the surrounding tissues, helping to heal the affected area.  It creates a soothing effect and helps to release spasm in muscles and increase the flexibility of the soft tissues.  As with ice therapy, heat should only really be applied for a maximum of 10 minutes to an area and the heat source used (hot water bottle, gel pack etc.) should not be too hot and should be wrapped in a tea-towel to ensure that it doesn’t burn the skin.  Muscle injuries, 3-7 days post injury, generally respond well to heat therapy, whereas joint injuries tend to respond better to contrast treatment (see below) at this stage.



Contrast ‘bathing’ involves a mixture of ice and heat applications to the affected area.  This tends to be done in bursts of either three or five applications and follows the order ice-heat-ice – i.e the first and last application should always be ice.  This type of treatment is generally good in the ‘sub-acute’ phase of injury (i.e. over 72 hours post injury and up to 3 months following injury) and generally helps with the management of pain.





Although we try to use the above protocols as a general ‘rule of thumb’, every injury and every person will be different.  Some people can’t stand using ice, some people love it.  Some people get a great deal of benefit from using heat – others may experience a worsening of the pain.  Generally it will depend on what type tissue has been damaged, how long it has been damaged for – as well as the preference of the patient.  The best and most bespoke advice on this will therefore be given by your practitioner on full assessment and ongoing management of your injury.


For further information or to make an appointment with one of our osteopaths or our sports therapist – call us on 01354 694050 or e-mail us at