Treating Pain With Hot and Cold Therapy 2020 | Healthvibes

Treating Pain With Hot and Cold Therapy 2020. Which is Best?

This article is medically reviewed by Dr. Rajneesh Tripathi.

Treating Pain With Hot and Cold Therapy 2020


We used to see this question from years that when to apply warm fomentation and when to use cold fomentation. As in brief, we can suggest ice for acute and heat for chronic issues. To understand the concept of icing or heating in detail, firstly, all need to understand some basic medical terminology.


Video By Health Vibes


Which method is best for Treating Pain With Hot and Cold Therapy?

What is the difference between Acute and Chronic Injury?

Acute Injury

  • Any injury that occurs in the last 48 hours as a result of sudden trauma, collision, or fall can be counted within acute injury
  • Pain
  • Warm skin
  • Swelling
  • Redness
  • Tenderness

Chronic Injury

  • Any injury that developed slowly in a long time as a result of improperly healed or untreated acute injury.
  • Inflammation
  • Overall discomfort
  • Lifetime pain


Acute pain progresses into chronic pain when a continuous or repeated nerve stimulation take place a series of altered pain through peripheral or central sensitization and alteration in corticolimbic circuitry. The best screening which helps to identify the mechanism of chronic pain is The body map. In a body map, the doctor displays the various pain segments of the body with different colors. 

Hot Therapy:-

To understand the need or use of heat therapy also knows as hot fomentation, we need to understand the mechanism of it.

Mechanism of hot therapy (Warm fomentation)

Heat boosts the flow of blood and nutrients, which helps in healing or pain relief. Heat therapy provides circulation of blood, which helps to heal the damage first, then relax and soothe muscles while increasing the flexibility.

Types of heat therapy

  • Dry heat therapy– Dry heat is a heat therapy through conduction like heat pads, saunas, and other means.
  • Moist heat therapy– Moist heat is a heat therapy through convection like from the steamed towel, hot bath, etc. Moist heat is more effective than dry weather.

Most efficient Technique of heat therapy (Hot compress)

Always use heat devices like heating pads or hot water bottles with a temperature between 33 to 37.7 degrees Celsius. You can also use heat paraffin wax treatment. Rubs or balms also works with heat wraps.

Measures to be taken during heat therapy

People with the following pre-existing conditions should not be treated with heat compress-

  1. Diabetes
  2. Dermatitis
  3. Vascular diseases
  4. Deep vein thrombosis
  5. Multiple sclerosis

Risk of heat therapy

  • We should use warm temperatures instead of intense heating in heat therapy.
  • Heat therapy may increase the risk of spreading infection.
  • Heat therapy should not be last more than 20 minutes.

Cold Therapy:-

Cold therapy is also know Cryotherapy. To understand it’s usage firstly, we need to discuss its mechanism.

Types of cold therapy:-

  • Frozen Gel pack
  • Coolant sprays
  • Cold therapy chamber
  • Cryostretching to reduce muscle spasm during stretching
  • Cryokinetics is a combination of cold treatment with active exercises for ligament sprains.

Most efficient Technique of ice therapy (cold compress)

A cold compress or a chemical cold pack must be applied to the inflamed area for 20 minutes every 4 to 6 hours for three days.

By massaging with an ice pack in a circular motion for two to five times a day, for a maximum of 5 minutes.

Measures to be taken during cold therapy

A cold compress should not perform under the following conditions-

  1. Sensory disorder (can damage nerves).
  2. Poor circulation of blood.
  3. Stiff muscles and joints.
  • Never put ice directly on the skin. It may cause skin burn.
  • Risk of cold therapy
  • Nerve, skin, and tissue damage.
  • Cardiovascular disorder.


  1. Athletes or Sportsperson can use ice massage. Cryotherapy to reduce Exercise-induced muscle damage (EIMD) that can lead to Delayed onset muscle soreness ( DOMS)

2. In DOMS (Delayed onset muscle soreness), you need to take rest and cold bath. Cryotherapy helps in pain relief but does not repair tissues.

3. In Constract water therapy (CWT), you can use both heat and cold therapy to treat the pain.

4. People with chronic but non-serious injury or pain can try any method and find their solution.

Hot and Cold Therapy:- Which is best?

The thumb rule for this question, use heat for muscle pain or muscle stiffness. whereas, use ice in acute injury or pain with inflammation and swelling.


Treating Pain With Hot and Cold Therapy 2020 (Infographics)
Image From Health Vibes

Frequently Asked Questions (FAQ):-

When can we use both heat and cold therapy?

We can use both heat and cold therapy during pain caused by osteoarthritis, rheumatoid arthritis, back pain, fibromyalgia, neck pain, etc.

How do you do cold hot treatment?

We try to give this answer in a descriptive manner through our blog. In short, Basic heat therapy or thermotherapy can be done by hot water bottles or heat pads (heated in microwave). Whereas, cold therapy or cryotherapy can be done by cold pad (cooled in the freezer), cold water bottle, or ice. 

Should i use heat or ice?

The thumb rule for this question, use heat for muscle pain or muscle stiffness. whereas, use ice in acute injury or pain with inflammation and swelling.

Which therapy is best for tendonitis- heat or cold?

Firstly after injury, ice seems helpful especially for the first three days or so. Ice helps to numb the pain and constrict blood vessels.

Does heat helpful in nerve pain?

As per the Doctor’s advice, alternating heat and cold therapy increase the blood circulation which may help in pain relief. 

Is heat pack good for inflammation?

Heat therapy is helpful for treating inflammation (of various forms of arthritis), muscle spasm, and injuries such as strains and sprains.

How often i should alternate heat and ice?

When we apply cold therapy, the blood vessels contradict, which causes vasoconstriction. Vasoconstriction reduces the circulation of blood, which reduces pain. As we remove the cold or ice source vasodilation took place, which means veins expand.

As a result of vasodilation, circulation increases, which improves nutrient flow, helps in the healing of injured tissues. Alternating cold and heat proves to be very helpful in- OsteoarthritisExercise-induced injuries. 



Healthvibes has strict sourcing guidelines and relies only on academic research institutions and medical associations. We do not use tertiary references. You can read our editorial policy.

5 Sources