Open Mon-Sat · (03) 9859 5059 · BOOK online OR call Reception
Open Mon-Sat · (03) 9859 5059 · BOOK online OR call Reception

Dr Tristan Joss - Osteopath

Should I use heat or ice on this?
Who wins in the end??

Everyone you ask has a different opinion on whether we should use heat or ice to control inflammation, swelling & pain.

What about with chronic pains or acute sporting injury?

For a while my standard advice was try both and use what makes it feel better. Mainly because using an ice bath after a footy game was horrible and I didn’t feel any better!  

As much as we love helpful suggestions, what does science suggest?

Using Low level continues heat packs/wraps (Hotteze & Flexeze are examples) have shown to have the best results for reducing lower back pain, some studies have told us it’s more effective than ibuprofen and paracetamol medications!

By applying a low level heat pack for 8+ hours a day or night or whatever continues hours you choose, the heat penetrates the tissues and assists with the healing process, not just taking away pain.

 This type of hot help also allows us to return to exercise faster and movement is a major key to recovering from injury. They are even using heat wrap therapy in some hospitals after surgery to help with pain management.

Overall we have gone cold on ice but hot for heat.  We have been using the heat patches for a greater range of injuries with great results for our clients.  The great outcomes have been noticed with rotator cuff injury, back pain and hip issues.  As the research shows, and we have also found, that the Low Level Continuous Heat can provide considerable relief for pain.  Maybe it’s kick-starting the healing process to a greater degree?

Although there is some evidence suggesting ice is still good for an acute injury such as an ankle sprain, so we can stick with the “Rest, ice, compression and elevation” (RICE) protocol for acute injuries like rolling an ankle or bumping your head.

Other Conditions low level heat therapy is effective for:
  • Dysmenorrhoea (period pain)
  • DOMS (soreness after exercise)
  • Palliative care pain management
  • Prolonged sitting with long distance travel
  • IBS
  • Post surgery cramping
  • And even Blue bottle stings- for all you beach goers out there!


Heatpack Rules:
  • Be SAFE & Take care of your skin
  • Use a heat wrap or stick on patch, do NOT apply directly to the skin.
  • Longer lasting patches are better; 8-12 hours ideally
  • Remove if it’s too hot or your skin gets red, itchy or painful

Other pages that might interest you...

References List:
  1. Mayer J et al. (2005) Treating acute low back pain with continuous low-level heat wrap therapy and/or exercise: a randomized controlled trial. The Spine Journal Volume 5, Issue 4, Pages 395–403
  2. Scott N et.al. (2002)Continuous Low-Level Heat Wrap Therapy Provides More Efficacy Than Ibuprofen and Acetaminophen for Acute Low Back Pain. Spine Journal Volume 27 – Issue 10 – p 1012-1017
  3. Akin M et al(2004) Continuous, low-level, topical heat wrap therapy as compared to acetaminophen for primary dysmenorrhea. The Journal of Reproductive Medicine Volume 49(9):739-745
  4. Michlovitz S et al (2004) Continuous low-level heat wrap therapy is effective for treating wrist pain. Journal of physical medicine and rehabilitation Volume 85, Issue 9, Pages 1409–1416
  5. Loten C (2006) et al. A randomised controlled trial of hot water (45°C) immersion versus ice packs for pain relief in bluebottle stings. Medical journal of Australia, Volume 184: 329–333

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