When to use ice:

  • Joint sprain: Use ice on joints when the joint looks swollen and bruised; and it feels hot on touch. Mostly in acute (recent) conditions. Ice is also used in acute flare up in chronic conditions (long standing, origin more than a few weeks ago) e.g. 3 month old persistent shoulder pain increased recently due to excess work
  • Muscle strain: Use ice on muscles in acute injury followed with pain, muscle may look bruised as well

How to use ice:

  • Use either ice pack or ice cubes or a frozen bag of peas. Always cover the pack with a thin roll of towel to avoid direct contact of skin with ice
  • Ice should be applied between 15 to 25 minutes continuously and if required 3-5 times a day
  • Ice is particularly effective if applied in elevation as gravity will also help to decrease the swelling. The injured part needs to be higher than your heart


Aches and pain due to chronic injuries and chronic degenerative conditions like arthritis, spondylitis.
Heat increases the blood flow to the area, and relaxes muscles.

Don’t use heat on an injury that has happened in the last 48 hours (an acute injury). There may still be bleeding into the area and heat will make this worse.

How to use heat:

  • Use a hot water bag or a electric heating pad (at low intensity) or a squeezed towel soaked in hot water
  • For small joints of hands and feet, use bucket of warm water to dip the affected part. In swollen joints may add Epson salt to water for better effect (only occasional use and not to be used in diabetics, renal disease)
  • Application time 20 min