Ask the Doctor


Dear Dr. Eppler,

"As a patient, I see you often use ice and heat as therapies in your office.
When should I use heat instead of ice as a treatment for my condition?"

This is definitely the question I get asked the most from my patients. The short answer depends. Your particular condition and symptoms will dictate which of the two (or both) you will need to help you.


The application of ice or cold towels/compresses is done to reduce the temperature of tissues right below the surface of the skin. This cooling constricts blood vessels, numbs painful areas and helps relax muscle spasms in order to reduce pain and provide temporary relief.

Ice should be used to manage recent injuries. As a general rule, apply local cooling for 15-20 minutes several times a day during the first 24 hours. This will be effective in reducing and helping prevent swelling and inflammation.


Using heat raises the temperature of the tissues directly below the surface of the skin. This helps to calm tissues suffering from long-term spasms associated with chronic conditions. The benefits of heat are increased flexibility, range of motion and increased circulation to help speed the healing process.

There are many methods to apply superficial heat such as hot packs, warm, moist towels, heating pads and water bottles. Use caution when applying heat and don't allow applications to last more than 20 minutes.