Ice and Heat Treatment for Injuries

This leaflet gives a general overview of ice and heat in the treatment of soft tissue injuries. If you are uncertain about the use of ice or heat, consult a health professional such as a doctor, nurse or physiotherapist.


During immediate treatment, the aim is to limit the body's response to injury. Ice will:

  • Reduce bleeding into the tissues.
  • Prevent or reduce swelling (inflammation).
  • Reduce muscle pain and spasm.



Ice packs can be made from ice cubes in a plastic bag or wet tea towel. A packet of frozen peas is also ideal. These mould nicely and can go in and out of the freezer. However, frozen vegetables should not be eaten if they have been thawed and re-frozen. Purpose-made cold packs can also be bought from pharmacies. Take care when using ice and cold packs from a deep freeze, as they can cause ice burns quickly if used without care and proper protection.

  • Ideally, rub a small amount of oil over the area where the ice pack is to go (any oil can be used, even cooking oil!). If the skin is broken or there are stitches in place, do not cover in oil but protect the area with a plastic bag. This will stop the wound getting wet.
  • Place a cold wet flannel over the oil (you do not need to if using a plastic bag).
  • Place the ice pack over the flannel.
  • Check the colour of the skin after 5 minutes. If it is bright pink or red remove the pack. If it is not pink, replace the bag for a further 5-10 minutes.
  • Ice can be left on for 20 to 30 minutes but there is little benefit to be gained by leaving it on for longer. You run the risk of damaging the skin if ice is left on the skin for more than 20 to 30 minutes at a time.
  • The effect of the ice pack is thought to be improved if it is pressed gently on to the injured area.

Note: ice can burn or cause frostbite if the skin is not protected with oil and/or other protection such as a wet flannel.

Ideally, ice should be applied within 5-10 minutes of injury for 20 to 30 minutes. This can be repeated every 2 to 3 hours or so whilst you are awake for the next 24 to 48 hours.


When an injury is older than 48 hours, heat can be applied in the form of a wheat bag, heat pads, deep heat cream, hot water bottles or heat lamps. Heat causes the blood vessels to open wide (dilate). This brings more blood into the area to stimulate healing of damaged tissues. It has a direct soothing effect and helps to relieve pain and spasm. It can also ease stiffness by making the tissues more supple. If heat is applied to the skin it should not be hot; gentle warmth will suffice. If excessive heat is applied there is the risk of burns and scalds. A towel can be placed between the heat source and the skin for protection. The skin must be checked at regular intervals.

Do not use heat on a new injury. This will increase bleeding around the injured area and may make the problem worse. The exception to this is new-onset low back strains. A lot of the pain in this case is caused by muscle spasm rather than tissue damage, so heat is often more helpful than ice.

Ice causes a longer-lasting effect on the circulation than heat, and the painkilling properties of ice are deeper and longer-lasting than heat.

Both heat and ice can be re-applied after an hour if needed.

Do not use cold packs or heat:

  • Over areas of skin that are in poor condition.
  • Over areas of skin with poor sensation to heat or cold.
  • Over areas of the body with known poor circulation.
  • If you have diabetes.
  • In the presence of infection.

Also, do not use ice packs on the left shoulder if you have a heart condition. Do not use ice packs around the front or side of the neck.

Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Dr Helen Huins
Last Checked:
Document ID:
4525 (v39)
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