Ice or Heat for Shoulder Pain – An Essential Guide

The shoulder has a complex musculoskeletal structure with a versatile range of motion. When your shoulder undergoes damage, it does not move freely, causing severe discomfort and pain. 

The ball-and-socket joint in the shoulder has three bones: the scapula, the clavicle, and the humerus. These three bones’ optimal health ensures the shoulder functions properly and achieves the required range of motion. 

The shoulder also has the acromioclavicular joint between the clavicle and the scapula. The glenohumeral joint constitutes the humerus’s ball-shaped part and the scapula’s outer edge. 

These joints make the main shoulder joint the most mobile structure in your body because it engages the musculoskeletal structures and ensures the shoulder can freely move forward and backward. The rotator cuff is the primary area that optimizes the shoulder’s range of motion. 

So, this is how the shoulder functions. What causes shoulder pain, and whether ice, heat, or both therapies can relieve discomfort? Today’s article will explain everything in detail and based on evidence. Read on! 

Causes of Shoulder Pain 

Tendons are cord-like structures that attach muscles to the bones in the shoulder. However, when the tendon undergoes soreness or damage, it causes severe discomfort, inflammation, and pain. The shoulder pain usually results from the soreness of a rotator cuff. 

According to the National Institute of Health (NIH), the subacromial bursa’s soreness is a common cause of shoulder pain. Researchers state that most people experience soreness after physical activities, such as lifting a heavy object or playing sports. 

However, shoulder pain can also result from specific injuries. A 2022 study published on NCBI highlights that the shoulder blade and the arm bone form the shoulder’s main joint. The joint socket is shallow and encourages the arm’s range of motion. 

The rotator cuff has four muscles surrounding the arm’s bony structures. The primary objective of the rotator cuff is to keep the shoulder firm and steady as you move your arms. Bear in mind that shoulder pain is also due to the following: 

  • Arthritis in your shoulder joint 
  • Development of bone spurs 
  • Inflammation of a bursa, leading to bursitis
  • Shoulder’s dislocation 
  • Broken bones in the shoulder 
  • Shoulder separation 
  • Never damage 
  • Muscle and tendon soreness 

According to the National Library of Medicine, the shoulder contains various muscles, including the supraspinatus muscle resting on the shoulder’s uppermost part. The tendons connecting this muscle to the bony structures travel under the acromion. 

Researchers argue that this tendon usually undergoes injuries and damage because of its unique position between the bones. For instance, when the tendon experiences swelling, soreness, or inflammation, it becomes pinched between the two bones. 

At the same time, the tendon’s fluid that acts as a cushion undergoes damage, causing severe discomfort and pain. A 2022 study about rotator cuff injury highlights that a damaged cuff can cause severe pain in the outside or front of the shoulder. You will feel worse pain when raising your arm or lifting an object above your head. 

Ice and Heat Therapies for Shoulder Pain

The most common treatment options for shoulder pain are NSAIDs, such as naproxen, ibuprofen, and Tylenol. However, if these medicines fail to relieve the pain, your doctor will give you an intravenous injection called corticosteroid.

Physical therapy is another option to strengthen muscles, relieve pain, and improve the range of motion. The last option is surgery because conservative treatments have failed to alleviate chronic inflammation and pain.  

However, if you have acute pain and want to avoid the side effects of medicines, you can follow a more natural approach: ice or heat for shoulder pain. A 2022 article published by NIH highlights that cryotherapy, also known as cold therapy, reduces blood to the injured area, reducing swelling, inflammation, and pain around a tendon or joint. Cold therapy also reduces nerve activity, blocking pain signals to the brain. 

According to a 2014 study published by NIH, heat therapy increases blood flow to the injured area at elevated temperatures, producing analgesic and soothing effects on the muscles. Heat therapy also increases muscle flexibility and allows vessels to provide oxygenated and nutrient-rich blood to the injured area, relieving discomfort and pain. 

How To Use Ice Therapy?

Hundreds of research studies support ice therapy for shoulder pain and other injuries. It offers numerous physiologic benefits, including cooling superficial muscles and tissues, reducing inflammatory responses, preventing edema, and relieving pain. 

Use a moist, warm cloth over an ice pack to reduce the risk of shock and prevent muscle tightness, stiffness, and spasms. The warming sensation enables your shoulder muscles to adapt to the cold. 

The purpose is to prevent the sudden reaction to cold and reduce muscle tension/stress. Remember, this is an essential process because it decreases the risk of frostbite. 

So, after applying a moist cloth to the injured area in your shoulder, perform an ice massage. You can freeze water in a paper cup or foam and rub the ice directly on your shoulder. Avoid holding the ice in one spot for more than 3-5 minutes. 

Use a back-and-forth or circular motion to apply ice directly to the painful shoulder. Start the ice massage about 4-5 inches from the exact site of the pain or injury and slowly move toward the injured muscle, tissue, tendon, or ligament. According to Very Well Fit, the response to ice massage has four stages: 

Coolness: When you apply ice massage to the shoulder, you will feel cold immediately. The coolness sensation will progress and cause a little discomfort. 

Burning: The discomfort from a cooling sensation will turn into burning. The burning sensation will last for 3-5 minutes, depending on the duration of the ice massage. 

Aching: Although the aching sensation or feeling in the shoulder muscles has a short duration, it means the therapy/massage approaches the final stage, called numbness. 

Numbness: Continue the ice massage until you feel an analgesic effect or numbness. Stop the ice massage when your muscles, tissues, and nerves experience numbness. 

How Long Does Ice Therapy Take?

Generally, you can use ice massage or therapy for 20-30 minutes. However, this requires avoiding applying the ice directly to the skin. Most doctors advise their patients to place the ice packs in the freezer for 30-45 minutes. 

Then, remove the wraps or ice packs and apply them to the injured shoulder area to relieve discomfort, inflammation, and pain. Leave the ice packs for six hours in the freezer before applying them to the shoulder. 

Remember, this is necessary when you cool the cold therapy packs for the first time. Defrost the ice packs if you want to store them for a prolonged period. Wipe the ice packs clean and dry thoroughly before storing them in the freezer. 

How To Use Heat Therapy? 

Shoulder injuries usually occur unexpectedly, and you can use a standard ice pack to numb the injured muscle and relieve discomfort, inflammation, and pain. However, if your shoulder pain does not go away, you can use the heat therapy technique to heal the injured muscle, tissue, or bone. 

Unlike cold therapy, which numbs the injured shoulder and relieves pain, heat packs or moist towels increase blood flow to the damaged area, relax muscles, and loosen stiff joints. You can apply heat to the shoulder to warm up the muscles. 

The purpose is to warm up your shoulder muscles before performing pain-relieving exercises prescribed by your physical therapist. However, most people find it challenging to apply heat to the shoulder joint due to its increased range of motion and mobility. 

Most standard hot packs are challenging to apply due to the shoulder’s complex anatomical structure. For example, a shoulder strain may affect multiple structures, including the rotator cuff. So, using the standard heat/hot packs may not work. 

On the other hand, you can find hot wraps and packs explicitly designed for heating the shoulder. These products are similar to shoulder braces and are used for heat application. Bear in mind that you must not use them as braces because they are specifically designed for therapeutic purposes. 

You can use different methods to apply heat therapy and relieve shoulder pain. For instance, you can take a hot shower or hot water bottle for moist heat. However, we recommend using gel packs to perform heat therapy. 

You can also use specific infrared heat accessories to relieve discomfort and pain and speed healing. Moreover, heat therapy is reliable, effective, and safe when applied with care. Always consult your health provider if you are unsure about the heat application. 

Unlike ice therapy, which can relieve acute pain, heat therapy is unsuitable for recent injuries, particularly if you experience localized swelling and bleeding. Let us discuss how heat therapy or hot packs/wraps relieve shoulder pain. 

Blood Vessels Dilation 

Heat therapy is an excellent way to achieve blood vessel dilation, strengthen metabolic processes, produce an analgesic, pain-relieving, and relaxing effect, and sedate the sensory nerves. 

Accelerated metabolism in the shoulder area produces additional reactionary heat, releasing essential substances that dilate blood vessels and increase oxygenated blood flow to the injured muscles or tissues in your shoulder. 

Removes Toxic Waste Products 

A study published in the International Journal of Hyperthermia highlights that Heat therapy increases metabolism, allowing intracellular and intercellular processes to detoxify the injured area. 

It promotes sweating by opening the skin pores and removing toxic waste products that hinder healing. Therefore, regular heat packs for the painful shoulder relieve the damage and streamline the healing process. 

Relaxes Shoulder Muscles 

Heat therapy also produces positive psychological effects by relaxing the painful shoulder. Nerves in the shoulder area release pain-relieving chemicals and respond by boosting tolerate to heating. 

As a result, this produces a relaxing effect on the tense or stiff muscles and reduces the risk of excessive force needed for optimal outcomes. According to the Journal of Occupational and Environmental Medicine, low-heat wrap applied for 10-20 minutes reduces pain intensity, decreases acute muscular pain, and speeds up healing. 

Calming Effects on Shoulder Nerves 

Heat therapy relieves muscle spasms, increases blood lymph circulation, and boosts cellular oxygenation, nutrition, and detoxification. These multiple processes at the tissue level sedate and relax the nearby nerves and stop pain signals from reaching the brain. 

A 2015 review study highlights the physiological effects of heat packs, including increased blood flow, accelerated metabolism, and better elasticity of connective tissues. So, heat wraps or packs are an excellent choice for providing short-term pain relief and regulating cellular processes to speed up healing.

Final Words 

Depending on the type of injury, you may experience sharp aches or dull pain in the shoulder or under the blade. Some people experience burning, stabbing, electric, and tingling sensation in the shoulder. Sometimes, the pain radiates between the shoulder blade and neck. 

Take pain-relieving medications, such as aspirin, ibuprofen, or naproxen, to reduce inflammation and pain. In some cases, doctors prescribe anti-inflammatory drugs, analgesics, muscle relaxants, and opioids to treat pain in the shoulder. 

However, these medications can cause side effects when used for an extended period. Common side effects include dizziness, drowsiness, itching, sweating, nausea, digestive distress, increased tolerance or dependency, and a weakened immune system. 

On the other hand, ice or heat for shoulder pain is an excellent way to relieve inflammation, discomfort, and pain and speed up healing. The best thing about these proven methods is that they don’t cause side effects. 

If you want to achieve the best therapeutic effects and relieve shoulder pain effectively and quickly, make sure you apply ice for 20 minutes to narrow your blood vessels in the shoulder area.

Next, apply the heat packs for 15 minutes to dilate the blood vessels. Ice therapy, followed by a heat pack, pushes away inflammation from the painful or injured shoulder area. 

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