Is heat or cold better for nerve damage?

It depends on the type of nerve damage.

For some acute soft tissue injuries, such as a muscle strain, cold therapy works best because it helps keep down inflammation and numb pain. After 48 to 72 hours (once significant inflammation and swelling are under control), heat therapy often works best because it increases circulation and helps relax muscles.

For chronic pain disorders, such as sciatica, heat therapy is also often helpful because it can help improve blood flow and reduce muscle spasms.

Some types of nerve damage can be caused by chronic constrictive compression, such as Carpal Tunnel syndrome. For this type of nerve damage, cold therapy is more appropriate because heat may increase swelling around the compressed nerves, resulting in worsening of symptoms.

There are some cases where heat and cold therapy may both be helpful, for example, when there are both inflammatory (acute) and non-inflammatory (chronic) features to the nerve damage. In such cases, it may be best to do cold therapy for the acute or inflammatory phase of the injury, followed by heat therapy once inflammation and swelling are under control.

Heat should never be applied to an open wound of neuropathy, as it can be harmful to healing tissues.