Although that’s not quite how the quote goes in Hamlet, this age-old question is a common point of contention – and for good reason too! It can be confusing especially since research has flipped many times over the years between the potential advantages/disadvantages of heat versus ice in the management of muscle soreness.
It’s no surprise then that for many people, this poses a dilemma when it comes to deciding which one is better. Oftentimes decisions are made based on anecdotal evidence, which can be unreliable – so let’s take a look at what the scientific evidence is saying.
NB: the studies referred to in this article are based on people who experience delayed onset of muscle soreness (DOMS) after strenuous exercise, so this information may not be as applicable to those with muscle soreness after injury or surgery. There will still be some good takeaways but remember that this is all contextual and will vary between individuals.
The studies:
As mentioned above, the great debate between heat and ice has been shrouded in controversy – even within the academic community – for many years now. A study (Petrofsky et. al., 2015) of college students in their 20s-30s showed that there were advantages of both cold and heat therapy immediately after and in the days following exercise. It found that applying heat immediately after exercise was more effective for preserving muscle strength, however cold therapy was superior in relieving muscle pain.
More recent research also appears to agree with this – studies by Wang et. al. in 2021 and 2022 concluded that both heat and cold therapies were useful, with a heat pack yielding the most consistent and obvious benefits. Wolska et. al. in 2023 also found that if accessible, cryosauna (essentially a cryogenic chamber) therapy was effective in reducing the effects of DOMS.
Bottom line:
So what does this mean for you? The differences between how effective cold and heat therapy are varies between person to person (depending on age, lifestyle, fitness, etc) but even then, the differences are not significant enough to confidently lean towards one or the other as the superior option.
This might not be a completely satisfying answer, but based on the most recent evidence, the bottom line is that both modalities do for a fact help alleviate exercise-induced muscle soreness. Of course, whichever one you choose will be based on a variety of factors such as symptoms, preference and how you actually respond to either heat or cold. There is also the consideration of accessibility and affordability – most people do not have access to a cryogenic chamber!
Why not give both a go and see which one works better for you? As always, if you are ever uncertain, get in touch with a professional for further advice for your particular situation!
Wang, Y., Li, S., Zhang, Y., Chen, Y., Yan, F., Han, L., & Ma, Y. (2021). Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Physical Therapy in Sport, 48, 177-187.
Wolska, B., Domagała, Ł., Kisilewicz, A., Hassanlouei, H., Makar, P., Kawczyński, A., & Klich, S. (2023). Multiple cryosauna sessions for post-exercise recovery of delayed onset muscle soreness (DOMS): a randomized control trial. Frontiers in Physiology, 14, 1253140.
Yutan, W. A. N. G., Hongmei, L. U., Sijun, L. I., Zhang, Y., Fanghong, Y. A. N., Huang, Y., … & Yuxia, M. A. (2022). Effect of cold and heat therapies on pain relief in patients with delayed onset muscle soreness: A network meta-analysis. Journal of rehabilitation medicine, 54, 331.
