Physical pain is an unfortunate part of life, whether from a strained muscle, torn ligament, backache, headache, or age-related osteoarthritis.
Thankfully, cold and heat therapies are proven allies for relief. The challenge? Knowing when to reach for the ice pack or heating pad.
In this expert guide, sports medicine specialists, neurologists, and rheumatologists explain when and why to apply cold or heat. Read on:
Q: Cold or heat for arthritis?
A: Heat.
Q: Cold or hot for a gout attack?
A: Cold.
Q: Cold or heat for a severe headache?
A: Cold.
Q: Cold or heat for a muscle tear?
A: Cold.
Q: Cold or heat for a sprain?
A: Heat.
Q: Cold or heat for tendinitis?
A: Cold.
Q: Cold or heat for tendinosis?
A: Heat.
"Ice packs feel cold and harsh, while heat provides soothing comfort," notes Dr. Anne Rex, a sports medicine surgeon. "Yet cold is essential first for acute pain, inflammation, or swelling—heat can worsen it by prolonging inflammation."
Physical therapist Carol Ferkovic-Mack, a contributor to Sports Health, adds: "Moist heat relaxes muscles before activity or stretching, while cold after reduces pain."
"A reusable thermal mask or moist cold compress on the forehead, eyes, and temples eases migraine throbbing," says neurologist Jennifer Kriegler. Heat via a warm washcloth can also relax neck spasms contributing to headaches.
Heat is best for arthritis and injuries lasting over 6 weeks. "It relieves osteoarthritis pain in chronic cases," explains rheumatologist Linda Mileti. For acute gout flares, opt for cold instead.
Experts recommend 20-minute applications followed by 20-minute rests:
Ice packs: Use a commercial pack, frozen veggies, ice cubes in a bag, or reusable gel pouch. Continue past 48 hours until swelling subsides.
Refreshing massage: Freeze water in a paper cup, peel back to expose ice, and massage until numb—great for elbows or heels.
Reusable thermal mask: Chill for eyes or use a cold, moist towel on forehead and temples.
Moist heat: Soak in a bath, shower, or Jacuzzi at 33-37°C (warm, not scalding).
Self-heating patch: Ideal for neck muscles on the go.
Heating pad: Remove if heat feels uncomfortable to prevent burns.
Skip paraffin treatments—they overheat easily and risk burns. "Avoid extremes on numb areas like those affected by neuropathy, diabetes, or Raynaud's," warns Dr. Mack, as they can damage skin.
For fever with pain, cold is safe, per Dr. Kriegler.
Now you can confidently relieve pain with cold or heat—no more guesswork!
