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Both treatments are often used to ease pain, but when is it best to use each one?

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Injuries, exercise and chronic conditions like arthritis or fibromyalgia can cause aching joints and sore muscles. Although both ice and heat can ease joint pain, sometimes it’s better to use one over the other.

When should you use ice?

You may want to use ice if you have an injury or your joints hurt after exercising, moving furniture, gardening or other activities. Applying an ice pack to the sore area decreases blood flow, which relieves pain and inflammation. Inflammation can cause swelling around your joint, making it feel stiff. When you use ice, stiffness is less likely to be a problem.

Ice is most helpful when it’s used for the first 24 hours after joint pain starts. If you apply ice to your joint, be sure to follow the 20 minutes on/20 minutes off rule. Keep the ice pack on your joint no longer than 20 minutes. Wait at least 20 minutes before you use the ice pack again. Take the ice pack off sooner if your skin hurts or looks very red. Keeping the ice pack on your skin too long could cause frostbite.

When should you use heat?

When you use a heating pad or hot water bottle, blood flood increases. This makes it easier for oxygen and nutrients to reach your painful joints. Heat helps loosen tight muscles and joints and relieves pain and muscle spasms. If you have swelling, it’s best to use ice for 24 hours, then switch to heat. If swelling isn’t a problem, it’s fine to use heat when you first notice joint pain.

Although a heating pad can help you feel better, it can cause burns if you use it too long or the setting is too high. Don’t use the heating pad for more than 10 to 20 minutes at a time. Stop using the heating pad sooner if it worsens your pain or your skin begins to look very red.

If you don’t have a heating pad or hot water bottle, wet a washcloth, wring it out, then microwave it for 30 seconds. You can microwave the washcloth for a few seconds longer if it isn’t quite warm enough.

A hot shower or bath is also a good choice if you have aching muscles or joints due to an injury, chronic low back pain or arthritis. The Arthritis Foundation® suggests keeping the water temperature between 92 and 100 degrees when you take a shower.

When should you call a doctor?

If your joint pain doesn’t improve after you use heat or ice for a few days, or your pain gets worse, it’s a good idea to call your doctor. You may need other treatments that will help you heal and reduce your pain.

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Date Last Reviewed: August 16, 2021

Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. Contact Editor

Medical Review: Perry Pitkow, MD

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