Hot or cold? Which to use when

Hot or cold? Which to use when.


At Blackburn Osteopathy we are often asked by our patients whether they should use a heat pack or cold/ice pack for their injury.

As a good starting point the following general rule can be followed:

  • Sharp, acute, stabbing pain and inflammation/swelling – start with cold therapy.
  • Stiffness, ache type pain – start with heat therapy.

However, as there is always someone who will give conflicting advice and people have a tendency towards their own preferences, we at Blackburn Osteopathy like to let your body give you the answer.

Step 1:

If you have a movement restriction (eg. Difficulty turning your head to the right), try that movement and take note of how far you can turn. Also give a pain rating out of 10.

If you don’t have a movement restriction just rate your pain out of 10.

Step 2:

Apply either heat or ice pack using the above guide or your own preference for 10 minutes.

Step 3:

Take the hot or cold pack off for 30 minutes.

Step 4:

After the 30 minutes, retest the initial movement that was restricted – if the range has improved and/or the pain has decreased then the method you chose has helped. Continue to use as necessary.

If you are the same or worse than the original test, repeat the above steps with the opposite pack.

Consider keeping step 3 as similar as possible if you need to retest. Eg. If you have sat down for 30 minutes after taking the pack off in test 1, then try and sit for 30 minutes in test 2.

If neither a hot pack or cold pack give any real relief, you could still use one if it feels comforting and doesn’t aggravate your symptoms.

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