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Is Hot or Cold Therapy Good for Pain Relief and Healing?

A common question that patients ask is whether it is better to use hot or cold therapy for rehabilitation and pain relief.  

To answer this, we have to consider both the condition type and timing. These are some of the oldest forms of therapy and both have been shown to help with pain management and speeding up recovery.


Cold therapy is an important rehab protocol for acute injuries and flare ups. It acts to narrow the blood vessels resulting in reduced inflammation and swelling to the area of injury.  Additionally, when applied to the skin, the ice creates a numbing affect which helps with pain management. Different forms of cold therapy include ice packs, cold cloths, ice baths, crushed ice compresses, and ice cubes.  For example, if I were to slip on a patch of ice and strain my back trying to catch myself, icing for the next two to three days would be the preferred type of care.

  • Icing should last between 10-20 minutes.


Heat therapy is often used during the chronic phase of an injury.  The heat causes blood vessels to widen, thus increasing the rate of blood flow and allowing faster transport of oxygen and nutrients.  The heat also relaxes the tissue causing increased flexibility and range of motion, while reducing muscle spasms and joint stiffness.  Heat can be applied in various forms such as hot water bottles, electric pads, hot tubs, and warm towels.

For lingering low back pain that has been an ongoing issue, hot tubs or warm towels are my favourite forms of heat therapy!

  • Heat therapy should be done for 15-20 minutes