Call us directly: (717) 667-6640

217 Greenwood Ave. Yeagertown, PA 17009 View Location


The best rule of thumb for this question is always use ice first. Both of these at home treatments will help to decrease the pain sensation while applied, but ice has a physiological mechanism to decrease pain while the opposite occurs with heat. This physiological mechanism is what will prevent the pain from lasting longer and minimize the intensity of pain over time. We will briefly examine the reasoning for this.

Injury and the Inflammation process:

The body’s response to injury is the inflammatory process. This occurs due to cell wall injury which in turn releases chemical mediators. These chemical mediators are responsible for a few different actions. They first activate pain nerves (nociceptors) that cause the body to feel “pain”. Secondly they stimulate other cells to infiltrate the area and begin to repair and remodel the injured tissue. This is accomplished by the third mechanism of these mediators which is to increase blood flow and increase vessel permeability. This last action causes more chemical mediators, more pain and more blood flow which becomes a cycle of pain and swelling. This cycle will continue to occur to repair the injured tissue (48 hours to 6 weeks) and remodel the tissue (3 weeks to 2 years). This is the basic model of tissue injury and healing and MUST occur.

So, tissue injury occurs which causes the body to release chemicals and stimulate nociceptors and we feel pain. The process of feeling pain causes another body reflex which is to increase muscle tone around the injured area. This increase in tone is to guard the area and prevent additional injury and help promote healing. The majority of the time the body over does these two reflexes and the result is muscle spasm and severe pain. So, ICE or HEAT?

Ice and heat therapy will make nociceptors less sensitive to the chemical mediators which will decrease the feeling of pain while applied. The big difference is that ice has the physiological ability to decrease blood flow, which in turn will decrease intensity of pain and the amount of swelling and help keep the inflammatory response under control. Heat does the complete opposite, while applied it is making you feel comfortable and decreasing the pain sensation, but physiologically it is increasing blood flow which is increasing the chemical mediators of pain. So, to help prevent the muscle guarding/pain cycle from getting out of control USE ICE FIRST.

That is 20 minutes on and 1 hour off.

In short, get pain – use ice – do your stretches – call the office.

To a new year with better health ,



(717) 667-6640