In general use heat for old injuries and ice for acute or new injuries.
Old or recurring injuries usually do better with heat. The heat causes the blood vessels to dilate and bring more blood the area. The blood in turn brings more nutrients and oxygen to the area helping to relax muscles and reduce pain in the joints. The heat will also make the joints and muscles more flexible and so you will be able to move more easily.
Tips for using heat therapy
• The heat should be warm not hot
• The heating pad/ wheatbag/hottie or whatever the source of heat is, should not be applied directly to the skin. Put a towel in between the skin and the source of the heat
• Use the heat for up to 20 minutes unless otherwise suggested by your therapist or doctor
• Don’t use heat where there is swelling. Use ice first.
• Don’t use heat if you have poor circulation or diabetes
• Don’t use heat over an area where you have reduced sensation
• Don’t lie down on a heat source. You could fall asleep and burn yourself
• Dont use heat on an open wound or stitches
Cold therapy causes the blood vessels to constrict thereby slowing down the blood to the area , reducing or restriction the inflammation and helping to reduce the pain. It should be used with a new injury where there is increased swelling, bruising and pain.
Cold therapy is applied as an ice or gel pack. An ice pack can be bought from the chemist and kept in the freezer so that it is instantly useable when you need it. You can also make an ice pack up by folding some ice cubes in a wet tea towel and then crushing the cubes with a heavy object. A bag of frozen peas can also be used as a ice pack.
Tips for using an ice pack
• Put a moist towel in between the ice pack and the skin
• Leave the ice pack on for 15-20 minutes, ideally every 3-4 hours over the first 3 days. When you take the ice pack off the skin should be pink. It should not have gone white – if this is the case you may have given yourself an ice burn. It is a good idea to check the skin while you have the ice pack on.
• Try to make sure that the ice pack has molded to the shape of the area being treated
• Don’t use an ice pack if you have areas of loss of skin sensation
• Remember RICE for management of acute injuries

Rest (minimize movement of the injured body part)

Ice (apply a cold pack)

Compression (light pressure wrap to the affected body part can help minimize leakage of blood and swelling)

Elevation (raise the body part up so that the pressure from the blood and tissue swelling the affected area is reduced as the fluids drain from the area by gravity)
When you have joint inflammation from arthritis you should use ice. However remember that ice does cause stiffness so if you suffer from morning stiffness of your arthritic joints you may want to try heat in the morning and ice later on if your joints become inflamed and painful from over use.