Does heat or cold work better for acute muscle strain?
Evidence for heat is limited
A 2006 Cochrane review that addressed treatment of lower back muscular strain, not soft-tissue injuries in general, found moderate evidence that heat therapy reduces pain by 17% and disability in the acute setting (P=.001).8 The review also cited 2 head-to-head trials that compared heat and cryotherapy; however, the study designs were poor and the results were contradictory.8
Recommendations
Authoritative textbooks consistently recommend applying ice for initial treatment of musculoskeletal and soft-tissue strains.9
Acknowledgments
The opinions and assertions contained herein are the private views of the authors and not to be construed as official or as reflecting the views of the United States Air Force Medical Service or the United States Air Force at large.
