Heat VS Ice

Here is a question I hear a lot. Heat vs Ice which should I use?

Heat is for long term injuries it helps bring fluid into the area which is good for chronic injuries but is bad for fresh injuries since the area is already inflamed. The reason it relieves pain is that heat and pain travel along the same spinal tracts (or pathways) in your spine but the heat sensation overrides the pain sensation blocking it. Even though it’s actually doing more damage by bringing in more fluids. Ice on other had is great for fresh injuries. It helps drive out the excess fluid from inflammation. Which is why when you injure yourself in high school they tell you to RICE (rest, ice, compression, elevation). Probably 1/3 of all the patients I see are using heating pads for fresh injuries and as soon as I tell them to stop and switch to ice they feel tons better. Though that said if it is a long standing injury or a reoccurring one heat is the way to go.