A woman writing in a journal with a hot/cold wrap on her shoulders

Injury Guide: How to Alternate Hot and Cold Therapy

An easy to understand guide on properly alternating ice and heat therapy for healing and pain relief.


If you are combatting an injury and looking for treatment options, temperature therapy is likely on your radar. However, many newbies to these therapy options are unsure of what to do. Excessive heat or cold can slow the healing process!

There is a low-cost, low-risk treatment for pain relief that you can do at home. Contrast therapy centers around the idea of using both heat and cold on an injury to treat pain – in an alternation. Please reference this guide on how to alternate hot and cold therapy for an injury to ensure your success.

What is Hot and Cold Therapy?

Much like the name implies, hot and cold therapy involves combining and alternating cooling elements and heating elements to combat pain caused by an injury! This is a popular option because the risk is relatively low, and the start-up costs are affordable.

The Benefits of Hot and Cold Therapy

Ice is commonly used in the treatment of injury to lower inflammation and lessen pain. This practice, called cryotherapy, constricts blood vessels. This, in turn, causes muscle contractions and minimizes inflammation. However, it is essential to note that an excess of cold can lead to additional muscle tensions and spasms.

Heat therapy works by widening the blood vessels, which minimizes cramping and relieves pain in the process. When the blood flows more freely as stimulated by heat, more of the healing components of blood can reach a problem area. The biggest downside of heat is that overuse leads to inflammation!

A woman with a hot/cold wrap on her shoulder

Reusable Hot & Cold Therapy


"This product is indispensable. I know dozens of people who use them routinely. They are good for headaches, stiff necks, tummy aches, cold weather hands/feet, & muscle cramps or pain all over the body!" - Kate


Why Alternate Hot and Cold Therapy

By alternating heat therapy and cool therapy, one can avoid the muscle tension and spasms associated with cool therapy and the inflammation caused by heat. In addition, alternating heat and cool means relief for different pain as the injury changes – and provides an option for reducing inflammation, stimulating circulation, and loosening muscles all with one therapy.

How to do hot and cold therapy: Step by step instructions

Hot and cold therapy can be accomplished through a careful alternation of temperatures.

To put it very simply:

  • Apply cold for 1 minute
  • Then switch to 3 minutes of heat
  • Again use 1 minute of cold
  • Switch back to heat for 3 minutes
  • Apply your cold item for 1 minute
  • Heat the area for 3 minutes
  • Then wrap up the session with a cold application for one minute.
A graphic of a snowflake icon with a clock and “1 minute” in it
A graphic of a sun icon with a clock and “3 minutes” in it

This process should be repeated at most twice per day, dependent upon your injury and level of pain.

DIY Heat and Cooling Packs

To create a cooling pack on your own, take a frozen item and wrap it in cloth. This might be an ice pack or bagged frozen vegetables such as corn or peas. You may also fill a plastic bag with ice or place a towel soaked in cold water into the freezer for approximately fifteen minutes.

To make heating elements at home, try soaking towels in hot water then applying them to the skin. You can also fill a cloth item like a sock with white rice, seal it, and then microwave it for about one minute. If you have massage stones, you can heat these as directed by the manufacturer and use them. When doing heat therapy with homemade tools, be very cautious about the risk of burn – constantly checking the temperature before application.

Tips To Maximize The Effectiveness Of Hot And Cold Therapy

There are a few ways to improve your results with hot and cold therapy. First of all, it is essential to drink enough water and liquids. The body heals better when it is fully hydrated. Second, be sure to protect your skin from extreme temperatures, and stretch whenever you use heat therapy. Finally, you will want to be sure to use plenty of heat and increase the intensity of temperatures gradually as much as you can safely handle. Remember to always finish with an application of cold!

A graphic of a cup of water with a straw in it. Text, drink water and liquids
Various thermometers at different temperatures. Text, increase temperatures gradually
Various thermometers at different temperatures. Text, increase temperatures gradually
A graphic of a woman stretching. Text, stretch
A woman with a hot/cold wrap draped on her shoulders and upper back.

Hot & Cold Therapy for Your Neck & Shoulders


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Types of Heat Therapy

Local Application

Apply heat for 15-20 minutes to the problem area only via a heat pack.

Total Body Immersion

Immerse the body in a hot bath for 30 minutes to two hours. Monitor the changes in pain and halt heat treatment immediately if inflammation increases.

Types of Cold Therapy

Local Application

Wrap a cooling item like an cold pack in a towel or cloth. Apply it to the affected area for 10-15 minutes. You can apply longer if needed, but no more than 20 minutes.

Total Body Immersion

Apply full-body cold via an ice bath or a cold therapy chamber. The recommended amount of time is 10-15 minutes. Be sure never to apply cold for over 20 minutes, as it can lead to nerve and tissue damage.

This article can provide additional insights into methods of applying both heat and cool therapeutically.

When Not to Use Hot Therapy

Heat therapy should not be considered for bruising or swelling. In addition, it is unsafe to use heat therapy if you have diabetes, dermatitis, vascular diseases, deep vein thrombosis, multiple sclerosis (MS), heart disease, hypertension, or are pregnant. If this is the case, you must speak to your doctor for approval due to an increased risk of complication.

When Not to Use Cold Therapy

Do not use cold therapy if you have a sensory disorder or diabetes. This may inhibit your ability to identify when extreme temperatures are causing damage. You should also not use cold therapy if you experience poor circulation or have stiffness in the joints or muscles.

You can learn more about when it is safe or unsafe to use heat and cool to treat an injury here.

When you suffer with pain from an injury, it can be tempting to overdo it with temperature for relief. When heat or cool isn’t helping or is even making it worse, follow the tips in this guide to properly use hot and cold alternation for relief and improved healing!

About the Author

Head shot for Brandon Landgraf

Brandon Landgraf is the Digital Marketing Manager for Carex Health Brands. He finds passion and fulfillment in creating content that enhances, improves, and enlivens others' quality of life. All of his written work is formulated to not only offer essential advice and tips but back it with proven studies and experts. His mission is to connect with readers and provide steps to make their lives better.

You can connect with him on LinkedIn here.

About Carex Health Brands

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Carex is your one-stop shop for home medical equipment and for products that assist caregivers with providing the best possible support and care for their loved ones. Carex Health Brands has been the branded leader in in-home, self-care medical products for over 35 years. Our goal is to improve the lives of our customers by bring them quality products that bring dignity back to their lives. With our three nationally distributed brands, Carex Health Brands serves national, regional and independent food, drug and mass retailers along with wholesalers, distributors and medical dealers.

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