Hey Doc, Should I use Ice or Heat?

I get this question in my practice nearly everyday. Let me clear this up for everyone so you will always remember it…

In any case where you are unsure what to do, use Ice first. Why, you ask?

Ice helps decrease inflammation and numb some of the pain/discomfort. Any acute injury or flare-up will cause inflammation at the injured location.

Remember, an injury does not have to be from a bad fall or accident (major trauma), it could result from something simple like bending over and feeling back pain or waking up with a stiff/achy neck (micro trauma). In either case, ICE FIRST.

Now, what is the exception to this rule…Of course you guys know there is always an exception, right? You’re thinking, “great, more for me to remember”…


IF and ONLY IF you are 100% certain that the pain/discomfort is a result of a Muscle Spasm you may use Heat right out of the gate.


Why heat for a muscle spasm, you ask? Heat will help sooth and relax the muscle spasm by bringing more blood to the area that heat is being applied to.

So here is the BIG Idea…At the onset of pain, use Ice and if you do not feel there is a muscle spasm, stick with Ice only. If your 100% certain you have a muscle spasm, use heat.

Apply Ice or Heat for 20-25 minutes at a time at the site of pain/discomfort and repeat this 2-4 times over several hours. Applying for over 25 min. or so in one sitting, has NO benefit…your body adapts quickly.

NEVER apply a heating pad/heat pack or ice pack directly on your skin, it is BEST to have at least 1 layer between you and the heat/ice. That can be a very thin towel or a thin shirt.

If your pain/problem persists for several days with no improvement from Ice/Heat, you may have a more serious problem that requires more intervention. Call your Chiropractor for a check up, you may need adjustments and other therapy to resolve the underlying cause of the persistent symptoms.


Hope this Helps!

Yours in Better Health,

Dr. J. Luis Sandez


Sandez Family Chiropractic & Wellness Center

Cary, NC 27513