When NOT to Use Heat for Pain

Post Workout InjuryI’ve shared before how heat can relieve muscle aches, joint pain and bring healing to soft tissue injuries.

And I’ve made no secret of how far infrared heat is the most effective way to bring deep, healing heat to your body outside of the sun itself.

Those wonderful sunrays – and likewise the safe, deep penetrating heat from far infrared heating pads – are shown in scientific studies to penetrate deep into joints and muscle tissue, warming you from the inside out.

That’s far better than typical heating pads which merely warm the surface of your skin.

But I’ve also found balance is crucial in every area of life, including the use of heat for pain. Which is why you need to know…

There are clearly times when heat will NOT be your best option.

So here’s a quick guide to help you determine whether you should use heat or ice for pain.

When Heat Is the Wrong Choice

Immediately following injury, your body responds with inflammation. We often talk about how chronic inflammation is bad – and it is – but inflammation remains a crucial part of your body’s normal healing process for a new injury.

It goes without saying that injuries hurt. Ice soothes inflamed, swollen tissues which helps reduce the pain and swelling accompanying a fresh injury.

Notice I said ice, not heat. Adding heat to a locally inflamed area may only exaggerate your body’s response to the injury and increase the pain.

That’s why the rule of thumb is Ice for Injuries.

Even better… remember RICE:

  • Rest the injured area
  • Ice it
  • Add Compression (such as with an Ace bandage wrap)
  • Elevate the injury

When and How Long Should You Ice an Injury?

The sooner you ice an injury the better. Your goal should be to begin icing within five minutes.

Normally you’ll want to apply ice for 20 minutes, then allow the area to rest without ice for 20 minutes. Repeat this process as much as possible during the first 48 to 72 hours following injury to relieve swelling and inflammation pain.

Again, don’t forget to allow the injured area to rest and recover, add compression and elevate an injury when possible.

Ice may also be helpful when dealing with a flare up of pain from a previous injury. But before you head to the freezer…

Wait! Before Icing an Injury, Read This

Just like there are wrong times to use heat, there are also times when ice may do more harm than good. Or at least create more pain.

Chief among those reasons you may want to skip the ice is when you’re dealing with something other than an actual injury.

Ice is great at reducing swelling and inflammation. But apply ice to a Charley horse (which is a muscle cramp, not an injury such as a muscle tear) or a sore back caused by overly tight muscles and those muscles may further contract – and create a lot more pain.

So before icing, know how to tell the difference between an injury such as a strain (torn muscle) or sprain (torn tendon), as opposed to a nasty muscle cramp or trigger point pain.

An injury is often recognized by localized, acute inflammation:

  • Skin redness
  • Swelling of the area
  • Sensitive to touch
  • Skin feels hot

If you recognize these symptoms, use the RICE protocol above.

When Heat Is the Right Choice

For muscle spasms, chronic pain and other non-immediate injuries, use heat. Heat relaxes tight muscles whereas cold tends to lead to further contraction.

More often than not, neck and back pain isn’t caused by an injury such as a torn muscle. Instead, it’s more likely a muscle ache or possibly an irritated nerve caused by longstanding muscle imbalances.

When in doubt whether you’ve actually experienced an injury as described above, try heat first. When dealing with chronic pain, heat usually wins the day over cold.

Still Not Sure? Try Both Heat and Ice

In the world of pain, sometimes your body will simply respond differently than someone else’s. That’s because pain can be a subjective experience which varies from one individual to the next.

If cold or heat makes your pain worse, it’s perfectly acceptable to try the opposite. My advice on choosing either heat or cold therapy will work in the majority of cases, but if it doesn’t for you, experiment to find out what works best.

Also, many find alternating between heat and ice can be helpful following initial treatment. This can be especially effective at breaking a recurring cycle of muscle spasms.

For example, if you have a Charley horse in your calf, apply heat and massage to help your muscle relax. Then alternate between an ice pack and heat to relieve soreness once the initial painful spasm has released. But start with heat to relieve the muscle cramp first.

Or if you sprained your ankle, use the RICE protocol to relieve pain and swelling. After a day or two of rest, ice, compression and elevation, you may find alternating heat and ice work well in speeding the healing process. But start with icing for the injury.

Be Ready for Injuries and Chronic Pain Alike

As the famous Scout Motto says, “Be Prepared.” In this case that means you should have a ready means of applying either cold or heat as needed. In my house, that’s the Iso-Wrap DeepHeat far infrared heating pad.

At 12” wide by 27” long, the Iso-Wrap is perfectly sized to wrap around any ache or injury, delivering deep, penetrating far infrared heat to soothe aching muscles and joints.

IsoWrap Far Infrared Heating PadAnd it’s small enough to take along anywhere I go as it easily packs down into its convenient travel case.

But you may be wondering how that fits with injuries. After all, you want to apply cold, not heat, to injuries. And that’s the secret behind our DeepHeat far infrared heating pads.

Not only does the heat penetrate far deeper than any ordinary heating pad…

Our Iso-Wrap DeepHeat Far Infrared Heating Pad Doubles as a Cold Pack!

Since the Iso-Wrap is perfectly sized to wrap around a leg, knee, shoulder or other injured area, I keep mine in the freezer so it’s ready to go as a cold pack in an instant.

If I get too carried away during my Muay Thai workout or get some other injury, I simply grab it from the freezer and wrap it around the injury.

Its 70 jade stones retain and transfer cold just like they retain and transfer far infrared heat… and easily wrap around an injury… so you’ll never have to thaw a bag of frozen vegetables trying to ice a banged up knee or sprained ankle again.

Best of all, the convenient Velcro straps hold the cold… or heat… exactly where you need it.

(Yes, our larger models can work as cold packs, too, but the Iso-Wrap works best for applying cold to a specific injury plus it’s small enough to fit in most freezers.)

When I need heat, I simply plug it in and turn it up. In minutes I get the deep, soothing heat I’m looking for. This all-in-one device serves up both heat therapy and cold therapy.

Now that’s relief!

Click here now to learn more about our dual-purpose
Iso-Wrap DeepHeat Far Infrared Heating Pad



Vatansever F, Hamblin M. Far infrared radiation (FIR): its biological effects and medical applications. Photonics Lasers Med. 2012 Nov 1; 4: 255–266.

Filed Under: Back Spasm, Far Infrared Heat, Pain Relief
Written By:  Updated:
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Jesse Cannone, CFT, CPRS, MFT

Jesse is the co-founder and visionary CEO of The Healthy Back Institute®, the world-leading source of natural back pain solutions. His mission as a former back pain sufferer is to help others live pain free without surgery and pharmaceuticals.

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11 thoughts on “When NOT to Use Heat for Pain”

  1. raymond zammit says:

    i liive in malta europe and not i am with tingling nedlees ans pins about 5 yearsi do the mri i go to chinese nedlees and more i make blood test they say i have arthrites the tingling in my feet is still with me i take 3 ativans a day 2 mg each i dont know what to do thanks respond me please

    1. stevec says:

      Hi Raymond we would encourage you to always speak with your doctor directly with any health concerns. You will also find many resources on our website which may help with arthritis including Dr. Wiley’s book, Arthritis Reversed, which we encourage you to read. You can still request a free copy here:https://securessl.losethebackpain.com/products/118/sp-arthritis-reversed-book

  2. Johnny says:

    These articles are all well and good but I yet to see one dealing with pain in the Testicles, any thoughts

    1. stevec says:

      Hi Johnny thank you for the suggestion. Several years ago I had occasional severe testicle pain over the period of several months, which I’m fairly certain was back-related. I understand the pain! We’ll see what we can do to address this in future articles. Steve Coombes – Editorial Director

  3. Bonnie says:

    What about the knot in your butt from sciatica?

    1. stevec says:

      HI Bonnie,
      Sciatica is actually a symptom of one or more of several root causes. You may find this article helpful: http://losethebackpain.com/blog/2012/09/12/buttocks-pain/
      Steve Coombes – Editorial Director

  4. Barbara White says:

    For my sciatica, heat seems to work better than ice- is that okay?

    1. stevec says:

      Hi Barbara,
      Those with sciatica will usually find heat works better than ice for relieving symptoms because sciatica is typically a long-term issue, not the result of a recent trauma. I suggest reading the article I shared with Bonnie which you may find helpful, too.
      Steve Coombes – Editorial Director

  5. Sandy says:

    Wow. Loved this article. I have had back problems since high school (over 50 yrs. ago). I try both cold and my infrared heating pad. In the summer my back reacts to high humidity as soon as I walk out the door. Usually my first thought is to apply ice which sometimes works. But, you answered my question because sometimes if I leave it on too long the pain actually gets worse. Thank you so much for explaining why this happens. I am a devoted fan of yours and appreciate all your suggestions. Sandy

  6. Melissa says:

    Great blog and advice on heat and ice! I enjoy reading all the good information on your site! Thankyou! 🙂

  7. N B M says:

    I enjoy reading your articles & blog!!!!very informative and practical…..i think common sense is one of the ingredients that help me or us understand how to relieve pain!!!keep up the good work!!!!

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