Recovering from an injury is no fun. Whether you hurt your leg during a game or injured your back while at work, the healing process can be a painful journey. However, there is some temporary relief available in these cases.
Enter hot and cold (or contrast) therapy. Cold therapy slows blood flow to the injury to reduce swelling. Heat therapy enlarges blood vessels and promotes blood flow so the body can deliver the nutrients necessary for healing.
We will discuss when to use hot and cold therapy below, as well as some tips and tricks for getting creative with treatment. We’ll also cover the ways to use the therapy based on the type of injury you suffered.
What Is Hot and Cold Therapy?
Hot and cold therapy is a treatment method that helps muscles quickly heal back to normal. Scientists believe that combining hot and cold treatments for muscle injury expedites muscle recovery.
Heat therapy enlarges your blood vessels to encourage blood flow while cold therapy reduces the pain from swelling in an injury.
When done correctly, hot and cold therapy can heal your injury without further complications during your recovery. Knowing when to use cold therapy and hot therapy will help you to understand the proper application methods.

When To Use Cold Therapy
Patients should have cold therapy done in the first three days from the occurrence or recurrence of the injury. It will reduce the pain response felt at the injury site and helps to lessen the swelling.
Cryotherapy is another name for cold therapy. One study found that while the temperature of the area of application dropped quickly within moments of ice making contact with the skin, the intramuscular temperature did not change until a half hour later.
Hence, you should not use cold therapy for more than 15 minutes to a half hour in one sitting. If you use it too long, you could get frostbitten. Once cold temperatures reach your muscles and stay at that temperature for too long, it can do more harm to your injury than good.
In the first few days post-injury, cold therapy will be your best friend to help with the swelling. Especially if you twist your ankle and limp as you walk, cryotherapy can work to reduce the swelling faster so that you can get back to walking like normal.
Cold therapy also helps with pain management. Lower temperatures can numb the nerves of the affected area, resulting in reduced pain.
People suffering from tendonitis could benefit from this therapy. Swelling ligaments are extremely painful, so the numbing effect of cold therapy can only be beneficial to patients suffering from tendonitis.
Similarly, arthritic patients could find some relief in areas where they can easily apply a cold pad or ice pack.
Apply the following to get the cold therapy you need:
- A DIY ice pack in a plastic bag with ice cubes. Wrap the bag in a washcloth or hand towel, depending on the type of injury. We will give you tips on creating a DIY ice pack or heating pack later in the article
- Apply an ice gel pack
- Take an ice bath
- Getting an ice massage from a massage therapist or loved one at home.
When To Use Hot Therapy
Heat therapy for injuries is best for relaxing muscles that are in pain post-injury. Do not perform heat therapy for the first 48 hours after an injury. Opt for a moist heat source rather than dry heat for more relaxed muscles. Moist heat can interact with deep muscle tissues and help them to heal faster than dry heat.
You can get moist heat therapy by taking a hot bath or applying steamed towels. Pick up a moist heating pack for even more convenient hot therapy without having to undress completely.
Dry heat therapy is easier to use and a great alternative to moist heat methods. Go to a sauna to sit and relax to heal your injury. Use a dry heating pack or a plug-in heating pad when you are at home relaxing to help your injury heal further.
Do not use hot therapy for too long to prevent burning. Keep a heating pad on your injury for up to 15 minutes for every hour that elapses.
The Benefits of Using Hot Therapy
Hot therapy is considered a vasodilator treatment that helps to make the blood vessel larger. As you continue to use heat therapy, you will feel less pain from the injury and more relief.
Stretched muscles can heal with proteins and amino acids already in your body circulating to the affected area. Since heat therapy enlarges blood vessels, it will bring the required nutrients to the injury site to promote healing.
Those undergoing heat therapy should consume foods high in zinc, vitamin C, vitamin D, and dietary fiber that also expedite muscle repair. Reach for a glass of fresh-squeezed orange juice, drink milk with your oatmeal, or have a grilled fish dinner with vegetables and legumes.
The Benefits of Cold Therapy
Swelling happens immediately after an injury because it is the body’s response to trauma. Cold therapy reduces inflammation and reduces pain from the injury. If you have a joint or tendon-related issue in your legs or arms, cold therapy could give you the relief you need.
If an ice pack isn’t close at hand, taking a cold shower can help. Hit the injured area with the cold water and you will feel a numbing sensation.
The Benefits of Alternating Hot and Cold Therapy
There are many benefits of hot and cold therapy such as:
- Reducing muscle tightness
- Enhancing blood circulation
- Keeping bodily functions regulated when switching between hot and cold
- It provides more relief than choosing only hot or cold therapy
- A balanced temperature harmonizes the healing process
Hot therapy gets your muscles warmed up before your workout or complete rehabilitation exercises after an injury. If you suffer from morning stiffness, use hot therapy to open up the blood vessels and increase blood flow to the affected area.
Mixing hot and cold therapy makes for the best treatment results since you get the best of both worlds. You get the benefit of an increased healing rate from heat therapy, while you also slow the inflammation thanks to cold therapy.
How Often Should I Use Hot and Cold Therapy?
Throughout the day, you can utilize hot and cold therapy multiple times but with some time precautions to protect your nerves. One hot and cold therapy session should last a maximum of 20 to 30 minutes. Do one session for at least 15 minutes to get the best results if your busy schedule does not allow it. Several 15-minute sessions a day should be enough to reap the benefits of contrast therapy.
Do Not Use Hot Therapy In These Circumstances
Some people with particular conditions should not use hot therapy. Certain issues could occur if you use hot therapy if you have the following conditions:
- Vascular diseases such as peripheral artery disease
- Diabetes
- Open wounds
- Multiple sclerosis (MS)
- Deep vein thrombosis
- Dermatitis
Since hot therapy rapidly influences your muscles, you should not use it if you have a pre-existing condition that affects your nerves. For example, multiple sclerosis affects one’s central nervous system by attacking the outer layer that protects the nerves from damage.
One type of vascular disease is peripheral artery disease. This condition attacks muscles in the legs and arms and prevents proper blood flow. In turn, your artery passages become narrower and unable to hold as much blood as usual. Considering that heat therapy expands blood vessels, those with vascular diseases could experience complications during therapy.
Too much hot therapy, in general, can cause inflammation. Cold therapy is essential for reducing inflammation, but there are some cases in which you should not use this treatment.
Do Not Use Cold Therapy in These Circumstances
You should not use cold therapy if:
- You have diabetes. Exposing the skin to low temperatures for long periods can cause irreversible nerve damage. Diabetic neuropathy is already a risk that can trigger nerve damage, so cold therapy will only aggravate the issue.
- You suffer from poor blood circulation because issues could happen during the short time that you are undergoing cold therapy.
- If your joints or muscles are highly stiff. These kinds of muscles will not respond well to cold therapy.
Excessive cold therapy can increase the probability of muscle spasms.
If you have an open wound around your injury, do not submerge it in an ice bath. Instead, use a gel ice pack wrapped in a washcloth for a safer cold therapy method.
While you don’t have to prepare much for a cryotherapy session, you should take extra care when taking certain maintenance medications. Stop taking blood thinners or aspirin when about to undergo cryotherapy.
Precautions for Using Hot and Cold Therapy
While using cold therapy, you should check that the injured area is not suffering damage. Touch the affected area with your whole hand or stroke it with your fingers to note if you have sensation. If you do not feel anything, stop cold therapy immediately and schedule an appointment with your orthopedic physician.
If you lose feeling in the limb or joint, stop cold therapy immediately.
The key to properly applying heat therapy is to keep testing whether the temperature is tolerable.
Keep tabs on the temperature of your heat therapy device. If you have a commercial heat therapy pad on your back, it will regulate the temperature accordingly to prevent burning. Set the heating pad to a moderate temperature and limit exposure time.
Elevate the feet when treating the swelling from a sprained ankle. This step ensures that the de-oxygenated blood that has accumulated in your extremities will circulate freely. Doing this should promote the circulation of nutrient-filled blood to the affected area.
Hot and Cold Therapy for Muscles
Hot and cold therapy for muscles should be in quick intervals to prevent nerve damage. Excessive cold therapy can constrict the blood vessels and cause nerve damage because of the lack of blood flow. An overabundance of hot therapy can cause first-degree burns.
Reaping the benefits of a hot and cold therapy routine is easy as long as you keep yourself on a proper schedule.
The best way to do this is to start with cold therapy and then end with it as well. Cold therapy should occur for only a third of the time that you take to apply hot therapy. For example, you can apply an ice pack for one minute and then a hot steamed towel for three minutes.
If you want longer application periods, you can have the ice pack on your injury for two minutes and the hot therapy on your skin for three minutes. However, faster transitions for alternating hot and cold treatment are better for the healing process.
The cold therapy will act as a quick solution to slow the swelling. Heat therapy, on the other hand, will allow your blood vessels to dilate so that the components for the healing process can get there quicker
Try hot and cold therapy for 12 to 15-minute intervals per day. Put an ice gel pack wrapped in a washcloth for a minute. Having the gel pack wrapped in a dry washcloth means that the cold temperature can slowly work its way into the swollen area without intense direct contact with the gel pack.
Then, follow up with three minutes of a dry heat or moist heat application of your choice. This could be a heating pad or a steamed towel or another heat therapy resource. Repeat this process until you reach the 12-minute mark.
Always end your hot and cold therapy session with a final cold application. If you want to extend beyond the 12-minute mark, you can repeat the process until around the 20 to 30-minute mark. Sessions should not last longer than a half hour to prevent overworking your nerves.
Hot and Cold Therapy for Back Pain
Hot and cold therapy is not just for bodily injuries. If you have back pain, this kind of therapy can help reduce discomfort.
Again, any type of hot and cold therapy should start with a cold application. If you have acute back pain that lasts for a month or less, you should use cold therapy until the inflammation subsides.
Find a cold pack large enough to cover the affected area of your back. Do cold therapy in 15-minute intervals at least a few times a day to reduce the swelling. The body’s response to an injury is to have blood rush to it for swelling to occur. Fluids containing white blood cells and other healing agents rush to the traumatized area. Applying a cold pack will essentially slow the blood vessels to control the injury’s inflammation.
As the inflammation ceases, you can start using heat therapy. Apply a heating pad or other source of dry or moist heat large enough to cover the pain site. You can use a commercial heating pad that sticks to your back for many hours of heat therapy. This allows you to enjoy the benefits of heat therapy even while you are at work or running errands.
Brace Direct Hot and Cold Therapy
Are you looking for a convenient product so you have less clean-up to do? Try one of our many hot and cold therapy units, such as the Brace Direct IcedHeat which is a heating pad and ice pack all-in-one.
When you purchase one of these hot and cold pads, you gain access to a fitting specialist. They will help to customize the heating and cooling pad’s fit based on your measurements.
Each pad comes with a tube connected to a machine that holds up to seven quarts of water at once. The tubing is leakproof so that you have peace of mind that the water will not leak onto your floor and possibly cause water damage during your hot and cold therapy treatment.
Rather than having to change from an ice pack to a heating pad and vice versa, all you have to do is switch the settings on the machine to the desired therapy that you need. If you prefer, you can set a timer for when the machine switches from hot to cold.
For example, start with cold therapy and set it to the lowest temperature available. After a few minutes, you can switch over to hot therapy by turning the knob to increase the temperature.
Additionally, the motor is not too loud so that it won’t distract you from whatever else you are doing. You can get the convenient treatment you desire without the extra noise of running the machinery.
The Brace Direct IcedHeat pad is great for those experiencing various types of conditions such as:
- Joint pain in the knees or shoulders
- Arthritis
- A sports injury
- Back pain
- Other painful muscle conditions
We also carry specialized devices for cold treatment along with fittings exclusively for body parts like the ankle, knees, and shoulder.
For example, the Brace Direct BlueIce Cold CryoTherapy machine is ideal for cold therapy. It has a large cold pad with small tubes that form channels underneath. The machine has an ice box with a built-in pump that brings the cold water from the ice box to the cooling pad. This design provides consistent cooling for large areas such as the waist or back.
Alternative Methods for Hot and Cold Therapy
When you do not have gel ice packs or a heating pad at your disposal, you can make DIY ice packs and heating packs with items that you have around home. Use your resourcefulness to help you heal!
DIY Heating Pack
Fill up white or brown rice inside of a clean sock or small pillowcase. Sew the end of it closed so that no rice falls out of the open end. Microwave the rice pack for up to a minute in the microwave. Meanwhile, the rice retains the heat from the microwave to act as an effective DIY heating pack.
Soak a hand towel of your choice of hot or warm water. Ring it out to prevent dripping as you relax. Apply the heated towel onto the injury as needed. Be sure to have your cold therapy nearby for when it is time to switch to it.
DIY Ice Pack
There are many ways to make an ice pack at home. Fill ice from your freezer into a plastic storage bag. Wrap it in a washcloth or hand towel so that direct cold temperatures do not come in contact with your skin.
Another method includes mixing three-quarters water and one-quarter rubbing alcohol inside of a plastic storage bag. Mix it as it is in the bag and freeze it for a few hours. Including the rubbing alcohol will make the contents get cold but not freeze over entirely so that it acts as a DIY gel ice pack.
Alternatively, you can grab a small hand towel, soak it in cold water, and freeze it in a plastic bag for 15 minutes. Be careful not to freeze it too long or the towel will get stiff.
If you do not have plastic storage bags, rubbing alcohol, or any ice available in the freezer, you can use any bag of frozen vegetables in a pinch. Whether frozen peas, corn, or carrots, if it’s a frozen food bag, it’s good enough to be a DIY ice pack.
Final Thoughts
Using an alternating hot and cold therapy system is essential for healing any injury or muscle pain in your body. While cold therapy reduces swelling, hot therapy relaxes the muscles to decrease pain response. Whether you choose a dual therapy pad or a bag of frozen peas and a towel to do it, there is no single correct way to do hot and cold therapy at home.
Take it easy while recovering from an injury. Use the methods above so you don’t exacerbate the damage done to your muscles. Happy healing!