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Heat or Cold for Neck & Shoulder Pain?

author image Aubrey Bailey
Aubrey Bailey has been writing health-related articles since 2009. Her articles have appeared in ADVANCE for Physical Therapy & Rehab Medicine. She holds a Bachelor of Science in physical therapy and Bachelor of Arts in psychology from the University at Buffalo, as well as a post-professional Doctor of Physical Therapy from Utica College. Dr. Bailey is also a certified hand therapist.

Damage to muscles, tendons that hold muscles to bones and ligaments that hold bones together can all cause neck and shoulder pain. These injuries can occur after trauma, such as a car accident, or might develop over time from overuse. Heat and cold can both be effective treatments for neck and shoulder pain; however, definitive research about these therapies is lacking. In general, ice is used immediately after an injury occurs, while heat is more appropriate 2 to 3 days or longer after an injury.

Cold Therapy

An injury to your shoulder or neck causes an immediate increase in blood flow to the area and leakage of fluid into the damaged tissue. This response might cause the area to feel warm and appear swollen. Ice helps to constrict blood vessels and minimize the accumulation of fluid in the area to reduce swelling. Ice also helps reduce discomfort by making pain nerves in the area less sensitive. When using an ice pack, wrap it in a protective layer such as a washcloth to prevent damage to your skin. Ice can be applied for 2 to 3 days starting immediately after injury. It is typically used for 10 to 15 minutes, every 3 to 4 hours.

Heat Therapy

Heat can be used to treat shoulder and neck pain beginning 2 to 3 days after an injury. If the injured area is no longer warm or swollen, you can likely begin to use heat. Heat increases blood flow to the area, decreasing pain, stiffness and muscle spasms that might also be present. Hot packs, warm water bottles and hot, wet towels are examples of heat applications for shoulder and neck pain. A hot shower might also be effective. Heat can be applied for 15 to 20 minutes at a time every few hours while your pain persists. Wrap a towel around your heat source to prevent burns, and never sleep with a heating pad.

Warnings and Precautions

See your doctor to get an accurate diagnosis of the cause of your neck and shoulder pain. If your pain does not subside within a few days or if it interferes with your ability to perform daily tasks, consult your doctor. Seek immediate medical attention if you sustain an injury and are unable to move your neck or shoulder, or have tingling or numbness in your arm. This can indicate a possible broken bone, torn tendon or ligament, or nerve injury.

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