May 30, 2019



Cold vs. heat, which one is better? I get asked this question almost every day in my practice. My short answer- it depends on what is going on with you!


Cold therapy works by decreasing blood flow to the area by narrowing blood vessels. It also works by slowing the pain messages being transmitted to the brain. The most common methods of cold therapy are ice packs, ice baths, ice massage, etc. There are other methods of applying cold therapy, such as full body cryo chambers that give you a systemic approach to reducing inflammation, as well as ice baths and simply taking a cold shower.

Cold therapy works by decreasing inflammation and swelling to the injured area, which is a big factor in what is contributing to your pain. Reducing swelling and inflammation helps to decrease pain.


Cold therapy can be used for acute injuries and pain, as well as to help get rid of swelling in a joint, tendon or muscle. It can also be used for sore muscles or tendonitis. Cold therapy should be avoided in those who have abnormal sensation in that area to avoid further injury, on open wounds, if you have peripheral vascular disease or on top of a cramping muscle.

Cold therapy, such as an ice pack, works best when applied for about 20 minutes on and 1-2hrs off at a time. This works to get rid of inflammation but still allows the healing process to take place.  Make sure not to leave your ice pack on too long to prevent tissue damage. If you are using an ice cube to give an ice massage, it is best to keep the ice cube moving, trying not to exceed more than 3-5 minutes.

Cryo chambers and ice baths deliver more systemic anti-inflammatory benefits and have also been shown to reduce DOMS, or delayed onset muscle soreness in athletes.


Heat therapy works by increasing circulation to the area by increasing the temperature and dilating blood vessels. Increased circulation can help to eliminate inflammation as well as aid in the healing process. Heat also relaxes tight and tense muscles and promotes relaxation. Heat therapy can be done locally, such as by using a hot pack, hot towel or heating pad. Heat therapy can also be done more widespread via saunas or infrared light. Research has shown that using moist heat, such as a moist towel or moist hot pack, works better than dry heat.


Heat therapy is best used for chronic pain, stiffness and muscle tension. Heat therapy duration depends on what you are using for your heat, but a typical moist hot pack can be left on for up to 2 hours depending on how hot it is and your comfort level. A dry hot pack can be left on for up to eight hours. As with an ice pack, make sure your heat source isn’t too hot and that you can feel the area to make sure you don’t burn yourself.

Heat therapy shouldn’t be used on open wounds, major swelling of an area or if an infection is present.


Contrast therapy involves using alternating heat and cold therapies. Applying heat for 20 minutes followed by cold therapy for 20 minutes, and repeating several times, is effective at increasing circulation more so than one therapy alone, which has a positive effect on the healing process and helps to reduce pain and inflammation.

Contrast therapy should be used in more sub-acute and chronic injuries vs. an acute injury.


Heat and cold therapy both work great! Knowing what you are using them for will ensure that you are using the best one for your problem. For example, use cold therapy on acute injuries and for moderate swelling. Use heat therapy for arthritis pains, chronic tension and for relaxation. Contrast therapy can be used on more sub-acute and chronic problems as well.

As always, listen to your body! If cold is making you feel worse than try heat, and vice versa. If you are heating or icing your injury and it is not going away you may want to consult your chiropractor or other provider to get to the root of what is going on.

If you are in Charlotte and need extra help, book an appointment today at our Charlotte chiropractic clinic to learn how to start living a more pain- free and active life. Also check out our blog and learn some helpful tips to have a healthier back here.

Author: Dr. Courtenay Schroeder

Owner & Chiropractor @ ProMotion Chiropractic

Medical Disclaimer
The information and reference guides in this website are intended solely for informational purposes only to promote consumer understanding and knowledge of various health topics. The contents of this website are not intended to offer personal medical advice, diagnose health problems or for treatment purposes. It is not a substitute for medical care provided by a licensed and qualified health professional. Please consult your health care provider for any questions or advice on any exercise, medication, nutrition or supplementation.

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