Sprained ankles, muscle pain or sore knees can be helped with the right treatment, but sometimes it is unclear which will help the most.


The safest choice for treating minor injuries, pain or swelling less than 24 hours old is with cold applications. Ice decreases pain and provides vasoconstriction (closing of small blood vessels). This helps limit the amount of swelling immediately after the injury as well as calm nerves. And remember the RICE treatment for acute injuries that involve swelling: Rest, Ice, Compression, Elevation.

More ice tips

  1. Ice or cold packs should never rest directly on the skin due to the risk of ice burn (frostbite).
  2. Wash the affected area with soap and water before icing if any lotion has been applied to the skin during the day. Lotion has a higher freezing point than skin and, when frozen, can cause an ice burn.
  3. Do not apply ice or cold packs for longer than 20 minutes. Wait until the skin has returned to normal color and temperature before reapplying.
  4. If the injured area is too small to treat with an ice pack, rub an ice cube over the affected area until it melts completely. Because the ice is in motion and not resting on the skin, it can be applied directly to the skin with less risk of incurring an ice burn.
  5. Soak a thin washcloth in cold water. Wring it out and place over the affected area. Place a bag of frozen peas or bagged ice on top. Frozen petite peas are particularly good for areas with hard to reach nooks and crannies (knuckles, wrists, ankles).
  6. For injuries affecting your hands or feet, you can also soak the affected area in a bowl of icy water for 10-15 minutes.


Moist heat promotes muscle relaxation and can be used on postural muscles (like those along the lower back, mid-back and neck) to treat sore muscles and spasms. However, avoid using heat for acute (new) injuries. When heat is applied to an acute injury, active inflammation or swelling can get worse as heat causes vasodilation (opening of the small blood vessels). Any bleeding in the area could also become worse if heat is applied.

More heat tips

  1. Heat should be applied for only 30-minute intervals. Wait until the skin has returned to normal color and temperature before reapplying. When using a heating pad, be careful not to burn your skin. It’s not uncommon for a person to fall asleep on a heating pad or to leave it on too long.
  2. Place a cloth layer between the heating pad and the skin. The first few times the heating pad is used, check the skin every 5 minutes to make sure the area is not burning.
  3. Set the heating device to the minimum level necessary to feel the heat. A higher setting is not better, just more likely to result in a burn.
  4. In a pinch, make your own heating pad by filling a sock with rice, tie it closed and microwave for 30-60 seconds. Test before applying to make sure the pad is not too hot to use safely.


Contrast baths (alternating cold and heat) can help reduce swelling in the extremities very quickly. This method promotes the opening and closing of blood vessels to pump swelling out of the area. For a contrast bath treatment, alternate placing the injured extremity in a bowl of cold (not icy) water and a bowl of warm (not hot) water, 5-10 minutes at time for a total of 30-45 minutes. This technique is not used specifically to control pain but can be effective in reducing swelling. It’s important to start and end with the cold bath.

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