Inflammation. A tasty rehab soup?

Ice or heat therapy for pain, which should you use? I explain it like this… It’s a soup!

A quick note before we start: this ‘recipe’ is an analogy to explain what inflammation is made of. It is not an instruction to injure anything — please don’t try this at home.

For this recipe you will need:

• One piece of soft tissue (muscle, tendon, ligament)
• 1 tsp – prostaglandin D2
• 1 tsp – prostaglandin E2
• ½ tsp – prostaglandin F2
• ½ tsp – prostaglandin I2 (which is also known as prostacyclin)
• 1 tbsp – thromboxane
• 5 ml – bradykinin
• A pinch of histamine to flavour

Method:

• Place the soft tissue in a vulnerable or weakened position. Repeatedly perform a strenuous activity until there is some discomfort. If you prefer to have the tissue already prepared, it may be called injured.
• Mix the remaining ingredients together in a bowl to create inflammation.
• Place the soft tissue on a surface and insert some of the inflammation into the tissue and rub the remainder over the surface.
• Leave to rest overnight, or until you feel an ache, throbbing, warmth or redness to the tissue, or sharp pain when moving.

The result, a delicious inflammatory soup!

Do I treat my injury with ice or heat then?

This is how I explain inflammation to my patients. It begins to make sense when it is broken down into smaller parts. Inflammation is not just one substance.

It is a mixture of many inflammatory chemicals — messengers released by cells that travel through the tissue and bloodstream to create a change elsewhere.

In an acute injury the cells surrounding the injured body part release these inflammatory chemicals. The role of each one is slightly different, but together they are part of how the injured tissue heals.

Some of them interact with blood vessel walls to relax them (vasodilation). This allows more blood flow to the injured tissue, bringing with it what the tissue needs to recover. Others interact with the nerve endings, sending signals to the brain, effectively telling you to stop doing what you are doing, or you will damage yourself further. This is a good thing. This signal is called pain.

The idea behind applying heat to an injury is that it increases blood flow to the area. It may help spasmed or tight muscles to relax and ease muscle stiffness, and it is used to support the tissue while it heals.

This is not to say that only heat should be used. Sometimes injuries are just too painful to deal with.

Discomfort can make it difficult to concentrate on tasks and can also make you partially or completely immobile. Here, ice can help. The cold can dampen the inflammatory response so there is less pain. The outcome of this is that you may be able to concentrate on a task or move more freely, which has the effect of relaxing muscles and improving blood flow… But only if you move! Ice can provide short-term pain relief, but neither ice nor heat should be treated as a guarantee of faster healing.

What the NHS advises for a new sprain or strain (added in the October 2026 review)

For a new sprain or strain, NHS guidance for the first 2–3 days is: rest and protect the area; if appropriate for you, apply an ice pack (or a bag of frozen peas) wrapped in a towel for up to 20 minutes every 2–3 hours; avoid heat — hot baths, saunas and heat packs — for the first couple of days; and gently resume movement as pain allows rather than staying completely still. Seek urgent assessment (NHS 111, an urgent treatment centre or A&E) if the pain is severe or getting worse, the injured area looks deformed or misshapen, you cannot put weight on it or move it, or it feels numb or cold. The NHS page is linked at the end of this article.

Of course, all of the above assumes the individual has no underlying health concerns such as chronic inflammation or any inflammatory disease.