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Ice vs. Heat - Which one is right for me?

Almost everyone has experienced an injury of some kind that required extra cares in order to relieve pain, reduce inflammation, and speed healing. Patients frequently ask me how to alleviate pain involved with this type of injury. The answer is that ice and heat are both recommended, but how do you know which one to choose?

Both hot and cold can be beneficial in certain circumstances; however, each can also cause more harm than good if applied at the wrong time. As a general rule, I recommend ice for acute injuries, those injuries that are less than 72 hours old, and where redness, swelling, sharp, and/or stabbing type pain is experienced. Acute injuries are usually due to some sort of impact or trauma, such as a fall, sprain, or collision. 

Heat, on the other hand, is recommended where pain is chronic and feels more like muscle stiffness, soreness and/or achiness. The cause of chronic injuries is often harder to pinpoint, since chronic pain can be subtle and slow to develop. Chronic pain can be the result of overuse, but may come and go, regardless of your activity level.

As with anything, there are always exceptions to any rule and where ice or heat are not well tolerated by an individual, or where a person has a known medical condition that would make ice or heat counter-indicated.  These modalities should not be used without medical or chiropractic supervision. Here are a few guidelines to help you decide on the best course of treatment.

The first general rule is to ice an acute injury and apply heat to a chronic injury. Swelling and inflammation is your body’s natural first response to injury - your blood vessels expand in order to rush more blood to the area to begin the healing process. In this acute situation, applying ice will cause the blood vessels to contract, reducing inflammation and bringing down the swelling, in addition to acting as a pain reliever by helping to calm irritated nerves.  Remember, the inflammation in an acute injury is a good thing—it’s your body’s initiation of the healing process.  Therefore, applying ice should be done first and foremost as a way to relieve pain.  Long-term ice application may actually slow down the healing process.  While icing, I also suggest some movement of the joint within pain-free ranges of motion.

ICE ICE BABY:

Ice or cold packs should never be applied directly to the skin, as this may cause frostbite. They can be wrapped in a damp washcloth or towel, or one can even use a bag of frozen peas. Ice should be applied to the injury for 15 to 20 minutes every two hours within the first 24 hours after injury. If the injury involves your hands or feet, these can be submerged in ice water for 10 minutes every 2 hours for the same effect. Cold therapy should generally not be continued beyond 72 hours, unless it is used to aid recovery after a strenuous athletic workout.

TIME FOR A HEAT WAVE:

Heat is most useful for chronic injury, as it increases blood flow, allowing additional oxygen and nutrients to speed healing and helping to relax tight and injured muscles. Heat should not be used immediately after an injury, as it may ultimately increase pain and swelling. For example, sitting in a hot tub may feel good, however, the following day you will likely feel more pain and stiffness due to the increased inflammation it has caused. Heat can also reduce joint stiffness and muscle spasms. Heat may be applied beginning 72 hours after an injury, assuming there is no inflammation in the area. Though a heating pad may be used, moist heat is the most ideal for healing, so you can apply a warm, wet towel or submerge yourself in a warm bath or hot tub for 10 to 30 minutes between two and five times a day. Warm rather than hot treatments should be used to avoid the risk of burns, and heat should never be applied for an extended period of time or while you are sleeping. Heat treatment is also useful in cases of chronic injury, such as overuse injuries in athletes, shoulder impingement syndrome, bursitis and tendonitis.

When it comes to injuries caused by physical activity, cold and heat are super beneficial, but they’re not long-term solutions. A healthy musculoskeletal system is critical to overall health and healing, affecting how the entire body functions. Regular chiropractic adjustments help reduce tension and pain by utilizing the body’s natural healing process. Choosing chiropractic as the first line of defense once injured decreases the likelihood of surgery and further injury. Bettendorf Chiropractic Wellness Center can help you with all of this and make sure you are feeling relieved of your pain and symptoms. Call today for an appointment at 563-359-5600.