The question I probably come across most in my practice is: When do I use heat and when is it better to use ice? Although the answer is somewhat complex depending upon symptoms and condition, one rule of thumb applies: Do not use heat on any fresh injury! During physical trauma blood vessels are broken and consequently blood will leak into surrounding soft tissue. Heat increases circulation, causing even more blood to flow into injured area. This will create more swelling and pain, as well as increased scar tissue formation down the road. My recommendation is to utilize only ice for at least 48 hours, if possible 3 times a day for 15 minutes. After 2-3 days you may begin to incorporate heat, preferably alternating with ice. I am aware that we are naturally drawn to heat for comfort in times of pain. However that could prove detrimental to your health if you have any inflammatory condition in progress. Unwanted increased blood flow will not only increase pain and swelling immediately, but furthermore cause scar tissue, followed by poor circulation, decreased range of motion and potential calcification of soft tissue in the future. This will inevitably make you prone to recurring injury, thus creating a vicious cycle. Using ice may cause initial discomfort, but should never be actually painful. Should this occur, you might be allergic or have a condition that makes you sensitive to those low temperatures. Check with your physician.
I do find heat very effective in treating mild muscle spasm, tightness and discomfort, providing it is not in an acute, inflammatory state. If an area feels hot and even throbbing, DO NOT apply heat. Use ice instead. I utilize heat quite often in my practice as a modality prior to massage. It prepares the area to be treated and invokes an overall feeling of relaxation. Hot Stones are a wonderful addition to all my sessions and popular all year round.