Hot and cold therapies are used to manage pain and inflammation, soothe muscles and speed up recovery, but how do you know when to use heat, cold, or when to use both?

What is heat therapy? 

Heat therapy, also known as thermotherapy, involves applying heat to a specific area of the body to relieve pain and discomfort. Applying heat increases blood flow and circulation, which helps soothe muscle stiffness and heal damaged tissues. Heat therapy can include using heat packs, hot water bottles, saunas and warm baths. 

What are the benefits of heat therapy? 

What conditions may heat therapy help with? 

Heat therapy can help with: 

How to use heat therapy as a complementary therapy 

If you’re managing pain or stiff joints from a chronic condition such as arthritis, here are some recommendations from the Arthritis Foundation1 on how to use heat as a complementary therapy: 

What are the risks involved in using heat therapy? 

While generally safe, heat therapy does have some risks: 

Heat therapy isn’t for everyone. Always consult with a healthcare professional before using heat therapy, especially if you have pre-existing conditions such as diabetes or vascular diseases. Always use a barrier (like a towel) between your skin and the source of heat to prevent burns and avoid using heat on inflamed areas or open wounds. 

What is cold therapy? 

Cold therapy, or cryotherapy, involves applying cold to reduce inflammation and numb pain. This method works by constricting blood vessels, which decreases blood flow to the affected area. Cold therapy includes ice packs, cold compresses, ice baths and cryo chambers. Cryo chambers expose the body to extremely low temperatures for a few minutes to reduce inflammation and aid in recovery, while an ice bath involves immersing the body in ice-cold water for a short duration. Athletes use ice baths to reduce muscle soreness after intense workouts. 

What are the benefits of cold therapy? 

What conditions may cold therapy help with? 

Cold therapy may help with: 

What are the risks involved in using cold therapy? 

While cold therapy is generally safe, there are potential risks such as: 

While effective for immediate relief, cold therapy should not be used for prolonged periods and it’s not suitable for people with circulatory issues or certain conditions. Apply heat for 15-30 mins at a time, and only apply cold for 10-20 mins at a time. 

Studies that support the use of hot and cold therapies 

When to use heat therapy versus cold therapy 

When considering heat therapy versus cold therapy, it’s important to understand when it’s best to use each one. 

Heat therapy is particularly useful for chronic muscle pain, helping ease tension and muscle stiffness and bring overall relaxation. Heat therapy works by dilating blood vessels, which enhances circulation and delivers more oxygen and nutrients to the affected areas. This increased blood flow can help reduce muscle spasms and pain while healing. 

In contrast, cold therapy is typically recommended to be pressed against an affected area immediately after an injury to reduce swelling and inflammation. Cold therapy reduces blood flow to the area, which slows down metabolic processes and decreases the inflammatory response. This is particularly useful during the first 48-72 hours post-injury when swelling is most pronounced.  

Cold applications can numb sore areas and decrease the perception of pain by slowing down nerve conduction, and may also help manage inflammation associated with flare-ups in conditions like arthritis.

Coaches and athletes often manage muscular pain by alternating between hot and cold therapies – a practice known as contrast therapy. This method creates a pumping effect in the lymphatic system as heat relaxes tissues while cold constricts them. Although there is anecdotal evidence that contrast therapy is effective in post-exercise recovery (Cochrane, 2004), there is a lack of scientific evidence to support the use of contrast therapy for either the treatment of injury or to aid recovery.5 

Always consult a healthcare professional before integrating any complementary healing practices into your treatment plan and pay attention to how your body responds.

Written by Stevie Bal 

Reviewed by Amber Foley (BNat, Grad Cert EvBCM, MNHAA) on 22 October 2024. 

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