Ice or Heat for Neck Pain: How to Choose

It happens to all of us — you sleep on your neck funny, or you finally sit up after a long day of being hunched over your computer, and suddenly sharp bolts of pain are radiating from your neck. If your knee-jerk reaction is to reach for ice or heat for neck pain, you’re not alone. It’s a common remedy to soothe a stiff, sore neck. 

But are you better off grabbing an ice pack or a heating pad? Is one better than the other? In short, no. “Both ice and heat can help your neck. They just help in different ways,” says Samantha Stewart, PT, DPT, a physical therapist at Hinge Health. 

In general, it’s recommended to ice a new neck injury, and to switch to heat after a few days to address any lingering pain or stiffness. “It’s not an exact science,” points out Dr. Stewart. “It often depends on what makes you — and your neck — feel better.” Ultimately, the goal is to provide enough symptom relief so that you can do things like exercise or physical therapy to improve the underlying causes of your neck pain, such as muscle weakness, imbalance, or tightness. This is what will lead to longer-term relief.

Read on to learn more about when to choose ice or heat for neck pain, plus alternative strategies that help ease discomfort, including neck and upper body exercises recommended by Hinge Health physical therapists.

Ice Therapy for Neck Pain

Ice (sometimes called cryotherapy) shrinks blood vessels, which limits blood flow to the sore area. “Icing decreases inflammation and inhibits the pain receptors in the area, which helps reduce pain and swelling,” explains Dr. Stewart. It may also temporarily numb nerve endings, which can relieve discomfort as well. 

You might benefit from using ice on your neck when you have:

• Neck spasms.

• A neck injury such as whiplash.

• Tension headache. These are usually related to your neck muscles, so calming those down can relieve pain, says Dr. Stewart. 

How to Use Ice for Neck Pain 

An important thing to keep in mind with cold therapy for neck pain is to limit putting ice directly on your skin or keeping it there for a prolonged period of time. You can wrap ice cubes in a paper towel, ziplock bag, or even a pillow case. Other ways to use ice include:

• Ice pack

• Ice towel

• Frozen pack of veggies

• Ice-cold shower

Whatever method you choose, Dr. Stewart recommends that you ice the area for no more than 10 minutes at a time.

How Often to Use Ice

It depends on the intensity of your symptoms, says Dr. Stewart. If you’ve just injured your neck, and the pain is intense, you can ice as often as once an hour for 10 minutes at a time. Otherwise, do it once or twice a day, or whenever discomfort flares up.

After about 48 hours, you may find that your neck pain is better relieved by heat, not ice, Dr. Stewart adds.

Heat Therapy for Neck Pain 

While ice therapy reduces blood flow, heat increases it. “A warm compress allows your muscles to relax and loosen up, and also brings more blood flow into the area, which can promote healing,” explains Dr. Stewart. Heat therapy is often recommended for chronic pain, as opposed to an acute injury. But you can use it whenever your neck feels sore, so long as it feels comforting to you. 

Some conditions when you may want to use heat for neck pain include:

• Muscle spasms.

• Neck arthritis.

• Neck pain when you wake up. “If you’ve slept in a funny position and find it hard to turn your head, heat is great to relax those tight muscles,” explains Dr. Stewart.

• Neck pain due to a herniated disc.

• Cervical stenosis, a condition where your spinal canal narrows at the base of your neck.

How to Use Heat for Neck Pain

Just like with icing, there are many different ways to apply heat. Choose the one that’s most soothing and comfortable to you. Try any of the following: 

• Heating pad

• Hot shower

• Hot water bottle

• Warm towel (pop a damp towel in the microwave for 30 to 60 seconds)

In each situation, you want to make sure the heat feels warm and soothing, but not too hot or burning. “You don’t want to scald your skin,” stresses Dr. Stewart.

How Often to Use Heat

You can apply heat multiple times a day, for 10 to 15 minutes at a time. “You can use it as often as you want in short spurts,” says Dr. Stewart. “I tend to be more concerned with how strong the heat is. You don’t want to fall asleep with it on your skin, since prolonged exposure can lead to a burn.”

When Not to Use Heat or Ice

While both ice and heat for neck pain have benefits, there are times when you shouldn’t use either, says Dr. Stewart. These include:

• You have an open wound on your neck. Using ice or heat on an open wound may increase the risk of infection. Check with your doctor first.

• You have neck swelling. You’ll want to skip heat in this case. Opt for ice instead.

• You’re sensitive to cold. In these cases, ice may make your neck pain worse. Try heat instead, or talk to your doctor or physical therapist about other options.

The above exercises are recommended by Hinge Health physical therapists in addition to using ice or heat for neck pain. While applying ice or heat can provide temporary relief from neck pain by reducing inflammation and soothing sore muscles, these treatments only address the symptoms. To fully address neck pain, movement and exercise therapy are essential. Regular movement helps restore flexibility, strengthens muscles, and improves circulation — all of which contribute to long-term recovery. 

Working with a physical therapist (PT) can help you develop a more targeted exercise program that’s specific to the neck pain you’re experiencing. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Listen to Your Body 

If you experience frequent neck pain, Dr. Stewart advises that you do a trial of both ice or heat (or sometimes one after the other). “Your body will tell you which one it likes better. Then pair it with movement to get the best results,” she says. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Garra, G., Singer, A. J., Leno, R., Taira, B. R., Gupta, N., Mathaikutty, B., & Thode, H. J. (2010). Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 17(5), 484–489. doi:10.1111/j.1553-2712.2010.00735.x

2. Isaac, Z., & Dec, K. L. (2022, September 20). Patient education: Neck pain (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/neck-pain-beyond-the-basics 

3. Senay Canikli Adıgüzel, Dilan Akyurt, Gökçe Ültan Özgen, Hatice Bahadır Altun, Aleyna Çakır, Mustafa Süren, & İsmail Okan. (2023). The Effect of Cold Application to the Lateral Neck Area on Peripheral Vascular Access Pain: A Randomised Controlled Study. Journal of Clinical Medicine, 12(19), 6273–6273. doi:10.3390/jcm12196273

4. Shin, H.-J., Kim, S.-H., Hahm, S.-C., & Cho, H.-Y. (2020). Thermotherapy Plus Neck Stabilization Exercise for Chronic Nonspecific Neck Pain in Elderly: A Single-Blinded Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 17(15), 5572. doi:10.3390/ijerph17155572