How Can Hot and Cold Therapy Reduce Muscle Pain?

How Can Hot and Cold Therapy Reduce Muscle Pain?

While exercise is beneficial to physical and mental health, athletes should take care to protect their joints and muscles. During exercise, blood is pumped to the muscles to deliver oxygen. Insufficient oxygen draws in lactic acid, which can cause soreness.

Small tears also form in muscles to help them grow bigger after a workout, causing discomfort. To minimize post-workout pain, stretching is essential. However, even with all of these precautions, unexpected injuries, such as sprains, may occur during physical activity.

Here are some useful tips for alleviating pain after exercise using hot and cold therapy.

When Should Cold Therapy Help Reduce Pain?

Cold therapy is most useful when swelling or inflammation occurs. For mild injuries, such as muscle spasms, an ice pack, cold cloths or ice bath can help reduce pain.

If using an ice pack, wrap it in a towel before applying to the skin for 15 to 30 minutes, maximum. Longer exposure may result in frostbite.

For more serious injuries, such as sprains, RICE (rest, ice, compression and elevation) is a standard method to promote healing. Rest, of course, will end any activity and avert further injury to the affected area. Apply ice for 10 to 20 minutes, 3 or more times a day.

Compression with a loosely wrapped bandage will further reduce swelling, followed by elevation of the injured area at or above the heart. This method is often effective within 24 to 48 hours of the injury.


When the body is exposed to cold, blood vessels constrict, decreasing blood flow and reducing swelling. As the body’s temperature lowers in response to the cold, numbness helps to alleviate pain.

If cold therapy is effective, the use of nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin, can be avoided. Although such drugs provide temporary pain relief, they can delay healing.

When Should Heat Be Used?

Alternatively, heat may be beneficial for stiffness or deep tissue injuries where the affected area is not swollen. It may also be used to warm the tissues before exercise. Heat can be applied with an electric pad, hot water bottle, hot gel pack or a warm bath.

A heat pack should always be wrapped in a towel. Any heat therapy should be used 15 to 20 minutes at maximum. Heat opens blood vessels to increase blood flow to the limbs, but prolonged exposure may cause burns.

Some injuries may be more stubborn. If the RICE method or heat therapy is ineffective and an injury persists for a week, a combination of ice and heat may provide better pain relief.

Hot and Cold Therapy During Training and Recovery

Hot and cold therapy, or contrast therapy, may have benefits in training, cooling down after exercise and alleviating injuries. Applying ice reduces swelling and pain, while heat increases circulation.


Using a combination of both methods creates a pumping action by alternating between dilation and constriction of blood vessels. This fluctuation between metabolic states encourages the body to heal quickly by reducing inflammation and loosening the muscles. For serious injuries, medical treatment is advised, but for mild injuries or soreness after a workout, this regimen may be effective:

  • Apply an ice pack or soak in an ice bath for 3 to 5 minutes.
  • Apply a hot pack or soak in hot water for 3 to 5 minutes.
  • Continue alternating between hot and cold for a total of 20 to 30 minutes, ending with cold to reduce inflammation.

This regimen may be tailored to suit one’s needs. For chronic pain, more heat may be indicated, while for inflammatory injuries, more cold should be applied.

Hot and Cold Therapy for Localized Injuries

For back pain, moist heat through a warm bath or shower may be more effective than dry heat. Alternating heat with the usual cold therapy methods can help alleviate back pain.

Hot and cold baths can also help with sprained ankles, neck pain and swollen joints. Many professional sports teams use hot and cold therapy for their athletes to hasten recovery after training or games. When used in tandem, hot and cold therapy has often shown to be more effective than one method alone.

Taking Precautions Before Hot and Cold Therapy

Individuals with the following conditions should take precautions before applying heat: diabetes, dermatitis, vascular diseases, deep vein thrombosis, multiple sclerosis, pregnancy, heart disease, hypertension and those with open or infected wounds. Avoid using heat when the injured area is swollen or warm to the touch, and use a warm, comfortable temperature, rather than burning heat.

Those with sensory disorders, cardiac problems, open or infected wounds, acute dermatitis or eczema, poor circulation or diabetes should not use cold therapy, as excessive exposure to cold may result in skin, tissue or nerve damage.

If an injury persists after using hot therapy, cold therapy or a combination of both, please consult your doctor.


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  • Artur B
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