Health Watch: When to use Ice or Heat on an Injury

Most of us have dealt with injuries at one time or another. Some of those injuries may have been serious, and others may just feel like those nagging and ongoing chronic aches and pains. Two types of self-treatments we’ve often used to deal with these common injuries are ice and heat. Almost everyone has used a hot bath to treat sore achy muscles or applied ice to a bruise or sprained ankle. However, few people understand how heat or ice affects an injury, when to use it, and why.

One of the most common questions I get in my office is when to use ice or heat for treating pain and injuries. Well, my answer is, it depends! Both can be beneficial at different times, but if used inappropriate during the healing phase of an injury,it might delay or exacerbate your state of injury. It is very important to treat an injury as soon as possible after it occurs because inflammation sets in rapidly and can delay healing if it’s not brought under control. So this begs the question, when should I use heat and when should I use ice?

When we first hurt ourselves we enter what is known as the ACUTE PHASE (first 24-48 hours) of the injury. This is when most inflammation and tissue disruption appears. It may persist between 24-48 hours and even longer depending on the severity of injury, or if the area is continually aggravated and not rested. The safest choice for treatment during the acute injury phase would be ICE. Ice decreases circulation to the area of injury, decreases the localized swelling/inflammation,decreases cellular activity, decreases muscle spasms, provides vasoconstriction (closing of small blood vessels) and alleviates pain. This helps limit the amount of swelling that occurs immediately after the injury.

Ice also has a calming effect on nerves, which can decrease pain. Ice or cold packs should never be put directly on the skin due to the risk of frostbite. In fact, cold packs can be even colder than natural ice. Neither ice nor cold packs should be used for longer than 20 minutes. Ice should be applied for 10-12 minutes every 1 to 2 hours. The application of heat is strongly contraindicated and should be avoided in the acute phase of the injury so as not to worsen the inflammation. You want to contain the swelling and inflammation, not make it worse! After the acute phase of an injury we can begin the healing phase and we enter what is known as the sub-acute, or if not treated properly, the chronic phase of healing.

The SUB-ACUTE AND CHRONIC PHASE of an injury is when the body will initiate repairs to damaged tissues. Acute inflammation will have dissipated but residual soreness/stiffness may remain. The application of HEAT will then be helpful. Heat will increase circulation to facilitate the repair of damaged tissues, favor tissue flexibility/extensibility, increases cellular activity, alleviate pain from chronic muscle tightness and will reduce the feeling of stiffness. Typically, I would advise heating for 15-20 minutes. Some caution though, needs to be used with heat. The danger of using a heating pad is burning of the skin. Commonly, a person will fall asleep on the heating pad or simply leave it on too long.

However, there are certain situations where usage should be avoided when using ice or heat such as:

• Severe circulatory conditions
• Lack of sensation
• Taking medication affecting the state of consciousness
• Danger of burns
• Malignant cancer
• Anemia
• Raynaud’s Disease
• Severe hypertension
• Diabetes with circulatory complications
• Internal bleeding
• Infection, open wound
• Skin disease
• Intolerant to heat or ice

If after a few days of treatment you have noticed only minimal improvement, consult your Chiropractor, MD, or physiotherapist. Remember, ice or heat is only part of the treatment for an injury. Stretching, strengthening, joint mobilization & /or manipulation, education, nutrition and prevention are important components to accelerating and optimizing healing and avoiding re-injury.

Yours in good health,

Dr. Victor St John DC

wwwstudiocitychiropractor.com

The Information contained Herein is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions.