A sports injury can cause both immediate and long-term pain. Many individuals looking for effective pain relief turn to heat or cold therapy, in addition to any other options that their healthcare provider may recommend.

But which is best for an injury: heat vs. cold? It's important to understand the pros and cons of each option before making a selection.

Heat Therapy for Injuries

The main goal of heat therapy is to enhance blood flow to the targeted treatment area. This is great for aiding with healing as well as improving range of motion and easing areas of stiffness. Many people use heat for chronic pain conditions, muscle strains, tendon injuries, tension headaches, and arthritic conditions.

Heat therapy includes two main options: dry heat and moist heat. Dry heat includes heating pads (available over the counter in drug stores and other retail outlets) and saunas. These are effective methods for applying direct heat to the afflicted area.

Saunas—including traditional dry saunas and infrared saunas—are becoming increasingly recognized for their many clinical benefits, including relief from low back pain. One systematic review of 40 studies found that in addition to alleviating chronic pain conditions, regular sauna use has beneficial effects on cardiovascular and rheumatological conditions and could even boost exercise performance in athletes.

Moist heat is considered a good all-around form of heat application. This type of heat modality includes warm baths, showers, hot tubs, whirlpools, and even moist hot towels or moist heat packs, which can be enjoyed in bouts of 15 to 20 minutes at a time.

When Should Heat Therapy NOT Be Used for Injury?

Generally speaking, you should avoid using heat on injuries that are considered acute or less than six weeks old. This is because the circulation-enhancing effects of heat may worsen inflammation and swelling.

Heat therapy should also not be used on areas with open wounds, as this could increase bleeding.

If you are being medically supervised for cardiovascular or vein-related diseases, or if you have areas of your skin with diminished sensation due to conditions like neuropathy, consult with your doctor before using heat therapy. Caution should always be used to ensure any type of heat therapy does not cause burns on the skin.

Cold Therapy for Injuries

Cold therapy is often recommended for acute sports injuries because it can reduce pain, inflammation, and swelling. While there is some debate over whether cold therapy could actually delay healing in acute stages of an injury, it still can be useful for minimizing discomfort, which may otherwise prevent someone from tolerating tissue-healing exercises as part of an early rehabilitation program.

Cold therapy includes frozen gel packs, bags of ice, and even bags of frozen peas or corn. These can be applied for up to 15 to 20 minutes at a time directly to an injured area.

Partial or whole body submersion in an ice bath can also be an effective tool for pain relief. Research suggests cold exposure triggers the release of endorphins within the nervous system, which are hormones that can block pain signals and improve mood and energy.

One major drawback: many people are less tolerant of cold than heat. This makes it an undesirable modality for some individuals. Even so, plenty of acute sports injuries can benefit from cold therapy, including ligament sprains, tendonitis, bursitis, and bruises.

When Should Cold Therapy NOT Be Used for an Injury?

Like with heat therapy, you should use caution when applying ice therapy over areas with diminished sensation. Ice therapy isn't ideal for stiff muscles or joints because the cold could exacerbate a range of motion limitations.

Cold therapy should not be used if you have poor circulation. In addition, never apply ice directly to the skin—this could lead to a freezing burn and additional tissue injury. Instead, wrap any ice or ice pack in a towel or rag, and perform regular skin checks.

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