Should You Use Heat or Ice for Sore Muscles?

Whether you have an ache, sprain, or strain, you probably want to try something quick and effective to soothe a sore muscle. Fortunately, there are lots of options. Heat and cold therapy can help with muscle aches and pains. So, you might wonder if one option is better than the other.

Learn the benefits of both to decide which treatment is right for you. 

When should you use heat or ice for sore muscles?

It depends on the cause of your muscle soreness and when it started. The science on ice versus heat for pain relief is mixed. But generally, ice may help reduce pain and swelling in the first 24 to 48 hours after new muscle aches, sprains, or strains. After the first couple of days, heat may be more effective for relieving pain and stiffness.

How does ice therapy work?

Ice or cold therapy narrows blood vessels, decreasing circulation to an injury. By slowing blood flow to the affected area, it can help reduce pain, swelling, and inflammation.

There are several ways to apply ice therapy: 

• Cold towels

• Ice packs or cold gel packs

• Cold-water immersion or ice baths 

• Coolant sprays 

• Ice massage

Some ice therapy applications, like whole-body cryotherapy chambers, are less accessible and may require medical supervision. But most methods are convenient and easy to do at home. 

Ice therapy benefits 

Ice therapy may reduce your sensitivity to pain by lowering nerve activity in the targeted area. This makes it a useful treatment option for acute injuries –– those that occur suddenly and have a known cause –– like swollen joints and tendons. 

Research suggests that ice therapy is most effective within the first hours after an acute injury. That explains why ice is commonly used after accidents like slamming a finger in a door or exercise-induced injuries like a pulled muscle. If pain and swelling don’t improve after a couple of days, stop using ice and talk to a healthcare professional. 

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Ice therapy limitations

Although it can treat new injuries, ice therapy may sometimes do more harm than good. Icing for too long may delay recovery. It can also cause the following symptoms and eventually damage your skin:

• Tingling

• Numbness

• Burning

• Itching

People with circulation or nerve problems from conditions like diabetes and neuropathy, should use caution when applying ice. That’s because decreased sensation in certain body parts can make it difficult to sense the potentially harmful effects of ice therapy. 

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Full-body methods like cold-water immersion can also affect your blood pressure and heart rate. If you have a medical condition such as hypertension, heart disease, or impaired circulation, talk to a healthcare professional before trying these methods.

How does heat therapy work?  

Heat therapy opens blood vessels, increasing circulation to the affected areas. Increased blood flow may help relieve pain, relax tight muscles, and improve range of motion.

Like ice therapy, heat therapy can be applied in several ways, including: 

• Hot towels 

• Hot water bottles

• Heat packs, pads, or wraps

• Saunas

• Hot tubs or baths

While saunas and hot baths provide a whole-body treatment, applications like heating pads and warm compresses target specific areas of your body. 

Heat therapy benefits 

Increased blood flow to the injury site may help your body repair damaged tissues. For example, heat therapy can help manage ongoing lower back pain, especially when combined with exercise. It can be beneficial if your injury is chronic. Overuse or chronic injuries usually develop gradually and last a long time.

Heat therapy limitations

There are downsides to heat therapy. If left on for too long, it can lead to skin burns. Avoid heat on areas with inflammation or open wounds. 

As with ice therapy, people with nerve damage from conditions like diabetes or multiple sclerosis should be careful when applying heat. If you’re pregnant, have heart disease, or high blood pressure, talk to a healthcare professional before using heat therapy. 

How long should you apply heat or ice?

Like any treatment, correctly applying ice or heat therapy is critical to reaping its potential benefits: 

• First, place a barrier, such as a towel or clothing, between the ice or hot pack and your skin to prevent burns. You can add additional barriers if needed. 

• Then, monitor the area for redness or other signs of irritation. 

• Generally, you can apply ice or heat therapy for up to 20 minutes at a time.

Do ice and heat therapy prevent muscle soreness?

The evidence for using ice and heat therapy to prevent delayed-onset muscle soreness is mixed. One review found that applying ice or heat within an hour after a workout can reduce muscle soreness. But there’s also some evidence that using heat therapy before exercise may decrease soreness.

Should you use ice or heat for pulled or torn muscles?  

A pulled muscle (strain) and a torn muscle are both soft-tissue injuries. Experts recommend ice therapy for newly pulled or torn muscles. Ice packs or cold treatments may help with pain, swelling, and inflammation. After a few days, you can switch to heat therapy to promote healing. Using heat before that can make inflammation or other symptoms worse. 

When should you combine ice and heat therapy?

In some cases, using both ice and heat therapy may be helpful. For example, you might use an ice pack for acute arthritis pain and a heat pack for ongoing joint stiffness related to your arthritis.

One study found that combining hot and cold treatments helped relieve knee pain due to osteoarthritis better than ice alone. 

When is contrast bath hydrotherapy necessary?

Contrast hydrotherapy is a treatment that involves alternating between hot and cold water. In contrast bath hydrotherapy, you submerge all or part of your body in hot and then cold water. You repeat the process several times. It may be helpful for exercise recovery or various conditions, including knee arthritis. A physical therapist might include contrast baths as part of a treatment plan to relieve pain, reduce muscle spasms and inflammation, and improve mobility.

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Written by:

Lauren Savage, MA

Lauren Savage, MA, is a health editor at GoodRx, where she focuses on movement, exercise, and healthy aging. She aims to provide readers with the information they need to live healthier, more active lifestyles.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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