Muscle pain or myalgia can be due to various causes such as muscle tension, overuse, or injury. Aside from adequate rest and over the counter pain reliever, heat or cold therapy can be an effective, safe and affordable home intervention. Knowing when and how to apply each method appropriately can help relieve your symptoms and prevent further complications.
Heat therapy for muscle pain
Mechanism of action: By helping your muscles to relax, heat can alleviate both pain and stiffness. It also encourages circulation and blood flow to the affected area. This help to get rid of lactic acid buildup that contributes to pain. Non-inflammatory muscle pain such as due to overexertion, muscle cramps and spasms may respond well to heat therapy. It is also useful at managing stiff, sore joints affected by arthritis.2
Method: Heat therapy can be applied using a heating pad, heated paraffin wax treatment, hot bath, hot shower or heat wrap to your sore area. Heat therapy works best by exposure for a period of time. 15 to 20 minutes of heat therapy can help relieve minor stiffness or tension. Moderate to severe pain can benefit from longer sessions of heat therapy like a warm bath, lasting between 30 minutes and two hours.3
Caution: Be careful not to burn yourself using heat therapy. Do not use heating cream along with a heating pad, and never leave the pad for too long. In case of inflammation as bruise or swollen, opt for cold therapy instead.
Cold therapy for muscle pain
Mechanism of action: Cold therapy reduces blood flow to the affected area, alleviating painful swelling and reduce inflammation. It also slows down the signal of pain from your nerves to your brain and has a numbing effect on the affected area. This can be helpful for fresh injuries.2 When tissue is physically damaged, inflammation will occur for a few days. This can be seen as skin that is sensitive to touch and is hot, red and swelling. Arthritis flare-up, for example, may suit more with cold therapy than heat therapy. Heat therapy can be counterproductive in this condition.
Method: Cold therapy can be applied through the cold tub, homemade ice pack or a bag of frozen vegetables, chemical cold pack or a cold washcloth. Do not apply the frozen item directly to the skin, rather wrap it in a towel. Limit its usage for short periods of time, several times a day. Elevate the affected area for best results.4
Caution: Those with sensory disorders such as diabetic individuals should not use cold therapy at home as they may not be able to feel if they overdo it. Cold therapy should not be used on stiff muscles or joints and if you have poor circulation. Be careful to limit your skin’s exposure to no longer than 10 to 30 minutes. Be cautious of hives or skin that turns purple, a sign that you’ve iced for too long.
Which one is the best?
Both heat and cold therapy can be useful when applied properly and are both cheap, easy, and mostly safe. If you’re trying to decide between cold therapy or heat therapy, consider the type of pain you have and where it is, what your doctor recommends, and what relief you personally get from each one.5
For example, if you are suffering from a muscle injury, it may be best to use cold therapy to reduce the inflammation for the first few days, followed by heat therapy to relieve pain. If you are suffering from arthritis, heat therapy can be useful with joint stiffness while cold therapy works best for swelling and acute pain. According to the Arthritis Foundation, either heat or cold may help with pain from arthritis.
The efficiency of both was also reported to be equal. In a randomised controlled trial comparing heat or cold packs for neck and back strain, the participants are given 400mg of ibuprofen orally and then the patients were given half an hour of either a heating pad or a cold pack.
The researchers concluded both heat and cold resulted in mild yet similar improvement in the pain severity. Adding either two of the method to ibuprofen therapy did not change the result. They recommend that the choice of heat or cold therapy should be based on your personal choice.
But even if most muscle aches can be relieved with home treatment, systemic muscle pain throughout your body may indicate an underlying medical condition that requires immediate attention. Consult your doctor if the pain is severe, does not subside after a few days or there is an accompanying symptom such as rash, tick bite, redness, swelling or fever.
Review Date: January 7, 2019 | Last Modified: November 29, 2019
Garra G, Singer AJ, Leno R, Taira BR, Gupta N, Mathaikutty B, et al. Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy. Acad Emerg Med. 2010 May;17(5):484–9.