Heat or Ice? A Chiropractor's Guide to Temperature Therapy

Dr. Joe’s Power On Podcast from Sheppard Chiropractic, Episode 46.

This episode of Dr. Joe’s Power On BODcast explains when to use heat versus ice for pain and injury management, and why choosing the right one matters for recovery.

Dr. Joe breaks down temperature therapy by explaining that heat works as a “relaxer,” improving blood flow, loosening tight muscles, and helping with stiffness and chronic discomfort. It’s best for issues like muscle tightness, arthritis, posture-related tension, and long-standing aches.

Ice, on the other hand, is described as a “calmer,” used to reduce inflammation, swelling, and acute pain. It’s most effective for fresh injuries, sprains, strains, swollen joints, and sudden flare-ups, especially within the first 24–48 hours after injury.

He emphasizes proper use of both therapies—applying them for 15–20 minutes at a time, avoiding direct skin exposure, and never sleeping with either heat or ice applied.

A key takeaway is the common mistake people make: using heat on a fresh injury, which can worsen swelling. Instead, a simple rule is “new injury = ice, chronic tightness = heat.”

The episode also introduces contrast therapy (alternating heat and ice) as a possible option for certain muscle-related conditions, though it isn’t appropriate for every situation.

Finally, Dr. Joe explains that while heat and ice can provide temporary relief, they don’t address the root cause of pain. Persistent issues may indicate underlying spinal or movement dysfunction, which chiropractic care aims to correct.

Overall, the message is that heat and ice are useful tools when used correctly, but lasting relief comes from identifying and treating the underlying cause of pain.

Transcript

SPEAKER_00 0:00

In the time it takes you to get home, work, or play, Dr. Joe's podcast will inform and educate you on chiropractic, nutrition, and fitness, keeping you and your family up to date on current products, health tips, and optimized living with chiropractic care. And here's your host, Dr. Joe Shepherd.

SPEAKER_01 0:27

Hello, my name is Dr. Joe Shepard of Shepherd Chiropractic. Today on Dr. Joe's Power On Podcast, episode number 46, we're tackling one of the most common questions patients ask in our office. Should I use heat or ice? It sounds simple, but you'd be surprised on how many people are using the wrong one for their condition. In fact, choosing the right temperature therapy can make a significant difference in how quickly you recover and how comfortable you feel. So today we're going to break it down when to use heat, when to use ice, common mistakes people make, whether you can alternate between the two, and when it's time to seek professional help. So kick off those shoes, take a deep breath, and maybe roll those shoulders back, and let's get aligned together. Okay, so before we talk about heat or ice individually, let's understand why they work. Both heat and ice affect the body's tissues, circulation, nerves, and muscles, but they do it in very different ways. Think of heat as a relaxer. It encourages blood flow, loosens tight muscles, and improves flexibility. Ice is more of a calmer. It reduces inflammation, limits swelling, and temporarily decreases pain signals traveling to the brain. Neither one is necessary better than the other. The key is using the right tool for the right problem. It's kind of like using a screwdriver versus a hammer. They're both useful, but not for the same job. So when do you use heat? Okay, let's start with that one first. You know, heat is generally best for a condition involving tightness, stiffness, or maybe chronic aches. If you've ever woken up feeling like the tin man from The Wizard of Oz, heat may be your best friend. Heat helps relax tight muscles, increases circulation, improves flexibility, reduces stiffness, and promotes movement. Great situations for heat are, you know, neck stiffness and neck tightness in your shoulders. Say you spend all day staring at that computer and you drove through Cincinnati traffic and you looked down or at your phone for three hours scrolling on social media. Now your neck feels like a concrete wall. Heat can help loosen those tight muscles and improve mobility. You know, chronic back stiffness, well, if your lower back feels stiff every morning after sitting for long periods, heat may help restore movement. Okay, arthritis. Many arthritis suffers find relief from heat because it helps reduce joint stiffness and improve flexibility. You know, after a tough workout or a weekend project in the yard, heat may just help relax those muscles and recover faster. You know, poor posture. Most of us spends too much time sitting. That posture creates muscle tension, especially around the neck, shoulders, and upper back. And heat can provide temporary relief while chiropractic care truly will address that underlying issue in your spine and your nervous system. So, how to heat safely? Well, here's a few guides. Apply the heat for 10 to 15 minutes at a time. Use warm temperatures, not a scorching hot temperature. Remember, you want therapeutic warmth, not cook your skin like a Thanksgiving turkey warmth. Moist heat often works best. Examples include maybe a warm towel, moist heating pads, or maybe a warm shower. And here's a big one. Never sleep on a heating pad. Every year people suffer burns because they fall asleep with heat applied for hours. So please use it wisely. So when do you use ice? Well, let's switch gears. Ice is your go-to choice when inflammation is involved. Think new injuries, swelling, acute pain, or recent flare-up. When tissues get injured, the body responds with inflammation. That's a normal healing response. But excessive inflammation can increase pain and slow recovery. Ice helps keep that process under control. Great situations for ice are maybe a fresh injury, you twisted your ankle, you pulled a muscle this morning, or maybe you fell off the bike this afternoon. That's when you want to use ice. I prefer icing for at least 24 plus hours, three days more, preferably. And generally, where ice shines, that's the best time. You know, sprains and strains, these injuries often involve swelling and tissue irritation, and ice can reduce both of the pain and inflammation. Whether you're a high school athlete, weekend warrior, or pick a ball champion, ice may be helpful immediately after an injury. If a joint is swollen, especially where you can see the swelling, ice is usually the best choice. Some people find cold packs on the neck and forehead to provide leaf during a headache episode or migraine. If your back suddenly goes out, as people call it, that means that inflammation is present and ice may your best, be your best calming friend at that moment. So, how do you use ice safely? You know, apply for 15 to 20 minutes. Always place a thin cloth or maybe towel between the ice and your skin. Never apply the ice directly to the skin for long prolong for prolonged periods of time. Doing so can damage the tissue and allow for about uh 45 minutes to an hour between applications. And just like heat, never sleep on an ice back on your body. Your skin will thank you. No one wants an iceberg. So, what's the biggest mistake people make? Well, let's talk about that one. A patient hurts their back, they immediately grab a heating pad. Seems logical, right? They got tight muscles. Pain equals heat or swelling. Unfortunately, that's not how people think. You know, if the injury is fresh and inflammation is present, heat will actually increase the blood flow and contribute to more swelling. That when things the symptoms will become much worse. So here's a simple rule. On a scale of one to ten, if ten's the worst pain, and three is say stiffness or soreness, then you want to do ice anything over four. Anything three or less, put heat on it. New injury, think ice. Old tightness and stiffness, think heat. It's not the perfect situation for everyone, but it's a pretty good starting point. Can I use both ice and heat? Well, absolutely. In some situations, alternating heat and ice are a good contrast and it may be beneficial at times. This typically means you put heat first, ice second. The heat helps relax the muscles and increase the circulation, and the ice helps calm the inflammation afterward. Some people find that contrast therapy is useful for chronic muscle tension and tightness, maybe a cramp or muscle spasm, or just stubborn soreness that won't go away. However, it's not always appropriate for every condition. If you're unsure, ask your chiropractor or health care provider what to do. So when are heat and ice just are not enough? Well, here's something very important. Heat and ice are tools, they are not cures. If the pain keeps returning after, say, a day or so, and they're not improving, and you're constantly trying to manage this pain by heating and ice packs, there may be a deeper issue you need to look at. I always tell people: after you injure yourself, give yourself maybe a day or so of ice. And if it's still there, you want to get it checked out to see actually what the underlying cause may be. And our goal at Shepherd Chiropractic is not to mask your symptoms. We want to identify what's causing your problem in the first place. Is there joint restriction? Maybe a spinal misalignment, muscle imbalance, poor posture, muscle dysfunction, nerve irritation. When we address the root cause, patients often experience more of an everlasting improvement. So let's be practical here. You know, one scenario: you spend eight hours at a desk, your neck and shoulders are really tight, no injury occurred. That's likely a hit a heat situation. Here's scenario two. You played softball on Saturday and twisted your knee, and it's swollen and painful, it's hard to walk. That is likely a nice situation. Scenario number three, you've had recurring back tightness for years. It feels stiff every morning when you wake up. Heat may help temporarily, but chiropractic care may be a better choice to find out exactly what's happening in your back. Here's that last scenario. Number four, you strained your back lifting 20 bags of mulch when you were trying to uh get that yard done for a party you're happening. Well, that area means you should be icing first. Okay, so there you go. So here's some my final thoughts. Remember, take these simple takeaways from today's podcast. Use heat for muscle tightness, some general stiffness, chronic aches, arthritic discomfort, maybe poor mobility. Use ice for a new injury, swelling, inflammation, acute pain, acute pain, and maybe a recent flare-up. The biggest mistake is using heat immediately after a fresh injury, you know, because everyone likes heat. People don't like cold. Can you alternate? Yes. Contrast therapy may be effective for certain muscle-related conditions. And finally, if you if neither heat or ice seems to help, it's time to investigate, find out what your problem is by calling your chiropractor. Thanks for joining me today at Shepherd Chiropractic Power On Podcast. If you're in the Cincinnati area and you're dealing with pain, stiffness, recurring headache, neck discomfort, or maybe a back issue, we'd love to help. Hey. Our office number is 513-753-pain or 7246. I hopefully you enjoyed today's episode. Share it with a friend or family member. And member who is always asking you, should I ice or heat after an injury? And as always, with that in mind, I look forward to speaking with you on your next visit. I appreciate you taking the time to listen to me with your busy home, school, or work schedule. And I've always said it's easier to build a child's future than repair an adult. Have a great week and thanks for listening.

SPEAKER_00 12:56

Thanks for joining us on this episode of Dr. Joe's Podcast. Discover more insights on chiropractic, nutrition, and fitness on next week's episode and at Shepherdchiropractic.com.