When Should I Use Ice and When Should I Use Heat?

This is one of the most common questions I am asked in my office.

Let’s break it down based on injury type and pain type.

Use ICE for the following:

  • Within the first 72 hours following injury
  • When visible swelling and inflammation are present
  • If pain is sharp, shooting, and/or has a deep ache
  • If you are experiencing pain at night that wakes you up because it is aches deep within your joint

Benefits of ice are:

  • Decrease pain
  • Decrease swelling and inflammation
  • Decrease secondary injury to surrounding tissues of the primary injured area

Use HEAT for the following:

  • After 72 hours if there is NO visible swelling or inflammation or redness present in the area
  • If pain is dull, achy, sore, or stiff
  • If you are experiencing pain at night that wakes you because it feels tight and sore

AVOID heat if:

  • Inflammation and swelling are visible
  • Redness is present
  • Possible infection or you have a visible open wound

Benefits of heat are:

  • Increase blood flow and...
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How a Shoulder Injury Can Create Back Pain

A few years ago, a middle-aged gentleman came to his physical therapy session because he was having back pain. After evaluating him, I learned that his back pain also created frequent “zinger-like” sharp shooting pain down his left leg. After about 3 sessions, his pain in his back and left leg were getting better and he was progressing exactly as I had predicted. This is great, right?

WRONG! He had no idea what had caused his back problem in the first place – which meant it was difficult for me to figure out the root cause of the problem so that I could really help his problem go away and not come back again.

During his 4th session, I was providing a special hands-on nerve treatment technique to his left leg while he was laying on his stomach. This technique, called the Myokinesthetic System™ was working very well in reducing the number of episodes of sharp shooting left leg pain. He was just chatting about how 2 years prior his right shoulder...

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