Applying Cold and Heat Therapeutically

Healing an injury or treating a painful condition can be significantly impacted by the appropriate application of cold and/or heat. Both cold and heat relieve pain and help with tight muscles, but other considerations (especially inflammation and depth of injured tissue) apply.


Apply cold immediately following any muscle, joint, or bone injury to relieve swelling, reduce pain and inflammation, and decrease muscle soreness and tightness. You can use cold any time after that. Cold only penetrates about 1 cm below the surface, so it works best for initial swelling/inflammation and for superficial conditions.

Do NOT use cold on broken or irritated skin, on superficial nerves, or when circulation is impaired. Also avoid applying cold when these conditions are present: Raynaud’s disease, cold intolerance, cold allergy, any previous experience of frostbite, impaired mental ability or sensation.

How to apply: Wet a cloth in hot water, wring it to dampness, wrap it around the cold pack, and apply. Check the skin in 5 minutes. If it’s bright red or numb, add another layer of insulation. Leave cold pack in place until it warms to room temperature. Repeat if needed. Never apply a gel pack directly to skin.


Apply heat in the recovery phase of an injury and later. Wait 3 days after injury for inflammation to subside before applying heat to reduce pain, relax deeper muscles, and make dense, tight tissue more elastic and pliable.

Do NOT use heat on acute injuries, inflamed tissue, broken or irritated skin, or with recent or potential bleeding. Also avoid using heat when these conditions are present: edema, blood clots, pregnancy, malignancy, any previous episode of heat exhaustion or heat stroke, impaired mental ability or sensation.

How to apply: Use a moist cloth next to skin to even out the heat and increase the depth of penetration.

  • Apply prolonged mild heat for up to 8 hours with over-the-counter heat wraps. These also help with chronic pain, joint stiffness, and general aches and pains.
  • Use spike heat by turning your heating pad to high (uncomfortably hot). Then turn off the heat and allow it to cool against the involved area for 20-30 minutes. Repeat once or twice if needed.

Painful muscle spasms

Apply COLD over the area of spasm and use HEAT either above or below the area. Try both positions to see which works best for you.

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