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Alternating Heat & Cold Treatment

Heat and cold treatment such as ice and heating pads can be alternated for reducing inflammation and pain (and healing muscles and tendons) caused by certain strains or injuries. However, there is an appropriate way to use both of them effectively. Ice is usually recommended initially to reduce swelling, and heat can be used effectively for promoting blood flow to the affected area. Ice and heat can be alternated to treat almost any surface muscle or joint in the body. Alternating hot and cold water can also be effective (hydrotherapy).

  1. Warning

    • There are certain diseases or conditions where alternating heat and cold can worsen a person's condition. According to orthopedic surgeon Dr. Stephen H. Hochschuler in his Spine-health.com article entitled "Ahh...Ice Massage Therapy for Back Pain Relief," "ice should... not be used for patients who have rheumatoid arthritis, Raynaud's Syndrome, cold allergic conditions, paralysis, or areas of impaired sensation." Moreover, diabetics, pregnant women and people with high blood pressure or heart conditions should probably consult their family physician before using heat.

    Effects of Ice

    • Ice is normally used during the first 48 hours after the onset of muscle soreness or an injury. The reason for this is that ice causes vasoconstriction (narrowing of blood vessels) which reduces inflammation and pain by limiting the flow of blood and lymph fluids to the area. It is this fluid, the body's natural response to strain or injury, that causes swelling and the consequential pain. Ice is most effective if it is directly compressed against the injured area at at 20-minute intervals throughout the day.

    Effects of Heat

    • After the initial couple days, when swelling has subsided a bit, heat can be used to promote blood flow to the affected injury. When heat enhances the flow of blood it also increases the delivery of vitamins, essential nutrients and blood cells, which help heal the affected muscle or tendon. Heat is usually most effective for more chronic injuries such as arthritis pain. Heat can be administered with heating pads or hot water bottles. You can also sit in a jacuzzi or take hot baths or showers.

    Benefits of Alternating Heat & Cold

    • Alternating heat and cold (ice) creates a vascular flush. This means that after ice constricts blood vessels, heat expands them and causes blood to flow more readily into the injured area. This type of therapy is believed to enhance the healing of injuries such as muscular strains or tendinitis. When inflammation is under control, heat can be used before ice. This allows healing agents from the blood to get to the injury, then the ice restricts blood flow and contains them. In addition to a heating pad and ice, a person can also benefit from using a sauna then taking a cool dip into a swimming pool. According to licensed massage therapist, Carol Wiley, in her bellevuemassagetherapy.com article "Hydrotherapy Basics for Home Use," "the general recipe for ratio of time for hot and cold hydrotherapy is three to one." That is, for every three minutes of heat, ice should be used for one mintue.

    Time Frame

    • Alternating heat and cold treatment can reduce the time frame in which you recover from a muscle strain or injury, especially if you are consistent.

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