As a chiropractor in Pensacola, FL, every day I am asked by my patients “Should I use Ice or Heat to help with my neck pain?”. There really is not one perfect answer and there are many factors to consider. One factor to consider is the source of your pain, aches, or discomfort. Is it from a car or auto accident injury ? Is it from a bad fall? Have you had the symptoms a long time? Is it achy and dull? For example, if you hurt or injure your neck in a car or auto accident, you will want to use ice within 48 hours of the injury. This is important because you want to reduce any inflammation in the neck due to swelling and/or tissue damage that was caused by whiplash. However, say your neck and upper back are constantly aching because the muscles are tight; using heat will draw the tension away by relaxing the muscles. In addition, you will want to alternate both cold and heat to reduce aches stemming from degenerative conditions and intense exercise.

So you’re saying sometimes use only Ice, sometimes use only Heat and sometimes use Both Ice and Heat?

Yes! Now let’s go over when each therapy would be effective!

Put some ICE on it!

Ice or Cold Treatment, also called cryotherapy, decreases the blood flow to the area, which helps reduce inflammation.  Some reasons to use ice or cold therapy would be for neck symptoms after a recent injury, whiplash, sprains or strains. There are also times you would not want to use ice, which include if there is a risk of cramping, the person is already cold and if there is an open wound or a decrease in sensation at the region. Do not put ice directly on your skin, instead use a towel or cloth to separate. You can use a cold compress or ice pack for 20 minutes every 4 to 6 hours. Another option would be to do ice massage, massaging the area directly with an ice cube for 5 minutes at a time.


Heat Therapies are usually more beneficial for muscle aches at the neck that are chronic, or ones that have been around for a long time. Heat therapies promote the blood flow to the area, which in turn relaxes the muscle to reduce pain. Heat therapy can be useful for warming stiff muscles, relieving muscle spasms, and reducing tension headaches. Some reasons to avoid using heat are if the skin is hot, red or inflamed, if you have dermatitis, the area is numb, or if you have a decrease in sensation at the region. Never fall asleep with a heating device on or attached to your body!

COOL it down / Warm it UP

Alternating cold and heat therapy is best for osteoarthritis and exercise-induced injuries. You should begin by applying ice or cold therapy to the area first. The cold causes the blood vessels to contract and the circulation is reduced and pain decreases, i.e. vasoconstriction. When the cold is removed the veins expand and circulation improves, the incoming blood flow brings nutrients to help the injured tissues. This process is amplified when you apply heat following the cold therapy. Using heat, also known as thermotherapy, is essential to the regrowth of damaged tissue. However, if you have neck pain and have suffered from a car or auto accident injury or a serious sport injury you will want to add thermotherapy only after the injury has started to heal.  Combining cold and heat therapies is best used about a week after the initial injury.

If your neck has been hurt in a car or auto accident, injured while playing sports or have nagging aches and pains that just won’t seem to go away, please contact a healthcare professional and have your symptoms properly evaluated.  Once the cause of your symptoms is determined, your healthcare provider can explain if you should Use Ice, Use Heat or Use Both Ice and Heat to help in the treatment of your condition.

If you have more questions or would like to schedule an appointment. Please contact Gilmore Chiropractic in Pensacola, Florida

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