Not every ache or injury requires a doctor’s care.

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Dr. Adam Culver

Some can be treated at home using hot or cold compresses – two inexpensive and highly effective do-it-yourself treatments. In this discussion, Dr. Adam Culver, a sports and family medicine doctor with Novant Health Waxhaw Family & Sports Medicine, helps us sort out what to use when.

What kinds of injuries require heat? And what's the best way to apply heat?

Heat helps increase blood flow. It’s great for muscle tightness, spasms and aches. It’s most often applied to the neck or back. It can be applied up to four times a day for 15 to 20 minutes at a time. The heating pad or other heat source should be warm and never hot.

Heat also works for arthritis pain and is generally used on the knees, feet and ankles.

And heat works to loosen up stiff joints and muscles before any physical or sports activity.

Think of heat as being useful for chronic, ongoing pain. It shouldn’t be used on bruises, open wounds or swollen areas.
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What kinds of injuries require cold? And what's the best way to apply cold?

Ice or cold therapy is more often associated with new or acute injuries. Ice should be applied to the affected area as soon as possible to get the most benefit.

Cold therapy is good for inflammation. It, too, can be used for arthritis, tendonitis, muscle strains and other painful conditions. Same rules apply – up to four times a day for 15 to 20 minutes at a time or as long as you can stand it.

You should have a barrier – a towel or something similar – between the source of ice and your skin; there’s the possibility of nerve damage if there’s no barrier and you use ice for too long. Ice packs are ideal, but bags of frozen vegetables will do in a pinch. Ice packs are preferable because they stay cold longer.

I’ve had athletes as patients who fill a Styrofoam cup with water, freeze it and use that. You can peel off a part of the Styrofoam and then use the cup like a roll-on.

I think the important thing is to understand that ice has some anti-inflammatory properties. It can be used in lieu of, or oftentimes in addition to, a topical anti-inflammatory. Heat doesn't have anti-inflammatory properties. Sometimes, folks ask me to choose one or the other. And if I had to, I would say I’m more of a fan of ice because of that anti-inflammatory property.

How would someone know when their injury or pain is beyond the help of an icepack or heating pad? When do they need to get to a doctor?

No matter if you’re using heat or cold, you should see benefit, even if it’s short-lived, after each session. If you don’t, you should consult a healthcare clinician.

Contact your doctor or get to an urgent care center for immediate or severe pain, swelling or an inability to put weight on the injured area. Of course, if there’s a sign of a broken bone, you should get to the ER right away. For many acute injuries, it pays to be seen by a doctor. It’s always better to err on the side of caution.


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