When should I use heat?  When should I use cold? 

Generally ice is applied in the case of acute injury and inflammation.  As soon as possible after injury or tissue damage.

Ice is an effective and natural analgesic (pain reliever)  and anti-inflammatory.  It also restricts circulation and thereby reduces swelling.

Ice should be applied over the inflamed area in the acute or early stages of your problem. (See below for application)

Whenever you experience swelling, redness or sharp / stabbing pain it is generally considered best to apply ice. Repeat until symptoms ease – usually for 24 – 48 hours.


Place ice cubes in a plastic bag or use a professionally prepared ice pack.

Place a damp face washer or tea towel over the affected area then place the ice pack on the material covering.

The first application should be as follows:-

10 minutes on
10 minutes off

10 minutes on
10 minutes off

10 minutes on

Then during waking hours, apply the ice pack every 2 hours, or as indicated by your Osteopath.

N.B. If you do not have ice immediately available, then use a pack of frozen peas or similar item.

For acute injuries that are red, hot and swelling; remember the First Aid acronym:



Compress (bandage)


Then seek appropriate help.

Heat brings blood, oxygen and other nutrients into a body region, which is usually helpful after damaged capillaries have healed (after 72 hours).  This is also helpful for longer term and persistant problems where circulation may be limited.

Heat is an effective therapy for reducing muscular tension and pain and is best used AFTER the initial inflammation has subsided.

Some injuries heal well in the initial phase, then plateau.  This is where alternate hot and cold can help to stimulate blood and nutrients into an area and also shift wastes and damaged cells out.  Follow the protocol below:

Cold 1 minute, then Heat pac for 3 minutes, then finish cold for 1 minute.  This will get a turnover of fluids and nutrients into and out of a stagnant area, thereby stimulating the body’d own healing abilities.

Heat should NOT be used at sites of infection as this should not be spread.

For further information, or to consult with one of our skilled Osteopaths you can use the Contact Us or Appointment Request buttons at the top or bottom of this page, call our Mosman practice on 0435 930 111, or visit Vital Lifestyle Centre‘s state of the art Osteopathy clinic at Middle Harbour Yacht Club. Ground floor, 75 Lower Parriwi Rd, in Mosman.

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