The first commandment issued in injury care is RICE. Rest, ice, compression and elevation are what needs to be done, usually for forty-eight to seventy-two hours. After that, which you choose depends on the injury. When you're dealing with the results of a disease, the rules can change.
Arthritis: When it's acting up, you may need both heat and ice. Before exercising or doing any strenuous movements, apply heat to the joints to help warm up. This can help prevent further damage from occurring and stop pain before it starts. After exercise, apply ice to cool it down and reduce inflammation.
These rules are great for osteoarthritis and rheumatoid arthritis, but you'll have to use more caution if your version is gout. Applying anything to the joint in an active flareup is usually far to painful to attempt. It's also wise to rest the joints involved during an active flare up.
Injury: Your doctor will give you a set amount of time and probably a minimum number of days you need to use ice on the injury. Most require a minimum, as mentioned above, of forty-eight hours, or two days. If the inflammation is still present after that, continue to ice it. After a week or so, you may be asked to alternate between the heat and cold, twenty minutes of ice first followed by twenty of heat.
Tendinitis: Treatment of this condition depends on the severity of the problem. You may find yourself in a cast, which doesn't allow for either heat or cold. However, if it is not that bad, use ice for at least two days. If you can warm up with physical activity, that might be best, but if not, use a hot water bottle or heating pad before you start moving around a lot.
Using hot and cold packs does have some common sense requirements. Don't let the ice itself touch your skin, as that can cause frostbite. Follow the guidelines your doctor gives; never leave an ice pack on for more than twenty minutes, and less if that is the recommendation of your physician.
Test heat from a hot water bottle on the inside of your wrist. If it is to hot for that sensitive area, it could burn you. Don't go to sleep with a heating pad turned on, as you could wake up with some serious burns. If you have poor circulation, carefully watch the time, as you may not notice that you have been using it too long. As with ice, the length of time for a hot pack is twenty minutes or less.
If you still have questions about which to use and for how long, ask your doctor. Be sure to mention any medical conditions you have as that could change the answer to your question.

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