To Ice or Not to Ice, That is the Question

To Ice or Not to Ice, That is the Question

Since I started practice over 10 years ago, there are a number of questions that patients ask repeatedly. One of those questions deals with the use of heat versus ice or cryotherapy . Cryotherapy is the use of cold therapy like ice, or Biofreeze which is a topical agent that acts like ice I will discuss Biofreeze more later. Patients will say that they feel better after a hot shower or a bath or sitting in the Jacuzzi, so why is it that I tell them to use ice and not heat. Well, that answer, folks, is quite simple.

First of all, we rarely should do things that merely feel good. After all, slouching feels good, but we all know that we should sit up straight (now is the time for you to adjust your position in your chair!). That being said, those of us who really enjoy icing, may say it feels good. In fact, I just took at 10 minute freezing cold water bath after running a 10-mile race, the Cherry Blossom Run, last weekend. Getting in, trust me, not fun. Getting out however, I felt like a new man. But, it shouldn?t really be about how it feels while it is on (the ice or the heat that is). What?s important is the feeling that you get after the 10-15 minutes of icing. Ice works, it can make you feel better, and feel better for a long time. Heat, on the other hand, only provides temporary relief. The reason it does that is because heat increases blood flow to the area and bringing blood to the area sounds good, but unfortunately, that process increases pain and inflammation. We need to decrease the pain and inflammation to achieve long term pain relief, and ice accomplishes that very well.

So, what is even better than ice? Remember I mentioned Biofreeze earlier. Research done recently shows that Biofreeze can actually be better than ice. It can have even longer lasting effects and is rated as more comfortable. This study was done on neck pain, but in practice we have no reason to believe that it wouldn?t help other conditions as well (currently, we are doing a study on shoulder pain). Today?s best practice in medicine is simple ? apply Biofreeze, then ice immediately after. Put that on for 10 minutes, remove for 10 minutes, and then put it back on for 10 minutes. This is going to be perfect for those sore and painful areas.

Either way, a lot of people still would rather use heat. I get it, but hopefully now you know the benefits of, the ease of, and how to properly use cryotherapy. Try it! It just may help you to live a happier and healthier life too!


Dr. Barton Bishop, PT, DPT, SCS, CKTI, TPI CGFI-MP2, CSCS
Chief Clinical Officer
Sport and Spine Rehab
[email protected]

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