Ice Or Heat After Injury The guidelines for use of ice or heat depend on the type of injury. There are two basic types of injury: Acute of Chronic. Acute pain is rapid onset and short lived Chronic pain develops slowly and is persistent and long-lasting Acute Injuries Acute injuries are sudden, sharp, traumatic injuries that occur immediately (or within hours) and cause pain. The most common signs and symptoms of acute injuries are pain, tenderness, redness, skin that is warm to the touch, swelling and inflammation. Ice or cold therapy is the best treatment for acute injuries because it reduces swelling and pain. Chronic Injuries Chronic injuries can be subtle and slow to develop. They sometimes come and go, and may cause dull pain or soreness. Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Heat should be applied before exercise and for pain control. Heat should not be applied after exercise. Cold therapy is also helpful in treating some overuse injures or chronic pain, especially after exercise. Ice or cold therapy should not be used before exercise. Application of Ice or Cold Therapy Apply for 15-20 minutes. Place a towel between the skin and the cold pack. Ice can be applied directly to the skin if tolerated. Never apply a commercial ice pack directly to the skin. Application of Heat Apply for 10-20 minutes. Be sure to use enough layers of towel between the hot pack and skin to prevent burns. Moist heat is best, so you could try using a warm wet towel.