Heat or Cold for Neck & Shoulder Pain?

Damage to muscles, tendons that hold muscles to bones, and ligaments that hold bones together can all cause neck and shoulder pain. These injuries can occur after trauma, such as a car accident, or they might develop over time from overuse.

Different injuries require different therapies. (Image: Tatomm/iStock/GettyImages)

Heat and cold can both be effective treatments for neck and shoulder pain. In general, ice is used immediately after an injury, while heat is more appropriate 2 to 3 days or longer after an injury.

Cold Therapy

An injury to your shoulder or neck causes an immediate increase in blood flow to the area and leakage of fluid into the damaged tissue. This response might cause the area to feel warm and appear swollen. Ice helps reduce swelling by narrowing blood vessels and minimizing the accumulation of fluid in the area.

Ice also helps reduce discomfort by making pain nerves in the area less sensitive. When using an ice pack, wrap it in a protective layer, such as a washcloth, to prevent damage to your skin. Ice can be applied for 2 to 3 days, starting immediately after an injury. It is typically used for 10 to 15 minutes, every 3 to 4 hours.

Heat Therapy

Heat can be used to treat shoulder and neck pain beginning 2 to 3 days after an injury. When the injured area is no longer warm or swollen, you can likely begin to apply heat. Heat increases blood flow to the area, decreasing pain, stiffness and muscle spasms that might also be present.

Hot packs, warm water bottles and hot, wet towels are examples of ways to apply heat for shoulder and neck pain. A hot shower might also be effective. Heat can be applied for 15 to 20 minutes at a time, every few hours while your pain persists. Wrap a towel around your heat source to prevent burns and never sleep with a heating pad.

Warnings and Precautions

See your doctor to determine the cause of your neck and shoulder pain. If your pain does not subside within a few days or if it interferes with your ability to perform everyday tasks, consult your doctor.

Seek immediate medical attention if you sustain an injury and are unable to move your neck or shoulder or have tingling or numbness in your arm. These symptoms may indicate that you have a broken bone, torn tendon or ligament, or nerve injury.

Reviewed and revised by Mary D. Daley, M.D.