That is a question I get from patients all the time. The answer is YES. Seem confusing?  It does not have to be.

Acute injuries such as ankle sprains or trauma to muscle such as a Charlie Horse most often require ice to control swelling as well as pain. Applying heat can cause a throbbing, achy pain in this situation. However, chronic conditions such as lateral epicondylitis, which is tendonitis of the elbow or more commonly called tennis elbow, benefits from icing to control tenderness and achy pain. Ice can thus be used to take the edge off of any painful area whether acute or chronic. Heat on the other hand is used primarily with chronic conditions such as long term muscle tension and muscle spasms. Heat helps to bring more blood into tight, adhesed, or spasming soft tissue to relax the area and reduce pain.

Sometimes the time of year can dictate your choice of pain control. For instance, a hot and humid summer day may not be the greatest time to apply heat to your neck or back. Likewise, a chilly fall or winter day may not be the best time to benefit from application of ice to the body. Some people just cannot stand applying ice and find it uncomfortable. Therefore, as a basic rule of thumb, if heat makes it worse try ice and if ice does not help try heat.

You should ice an area no longer than 15 minutes at a time and leave it off for about 45 minutes to 1 hour to let the tissue come back to body temperature. Heat can be applied for about 20 minutes with a similar break as ice. The body tends not to like having large temperature swings for too long so try not to sleep with ice or heat applied.