Knowing when to use ice and heat is very important. During the initial stages of injury (acute inflammation), ice/compression is the preferred choice for pain relief while controlling swelling. You will notice that professional athletes will often have a bag of ice taped to them as soon as the game is finished. This is because ice is especially effective if applied early and often after an injury.
Heat, in contrast can actually increase swelling (Oedema). This is especially true in lower back and neck injuries. Patients often make the mistake of putting heat on a recent lower back injury because the sensation of warmth on their skin initially feels comforting. What they don’t realize is that heat actually increases blood flow and pressure to the injured area. Nerves in particular are very sensitive to inflammation.
Acute inflammation can last 24 – 48 hours. This is followed by a period of decreasing inflammation (subacute) that can last 10 - 14 days.
Heat is most effective when used on long standing problems that have become chronic. Sometimes it is desirable to increase blood flow to promote healing and to stretch tight muscle.
Switching between heat and ice is often done to treat areas that have poor blood flow, such as ligaments and tendons.
If you have trouble remembering what to do in an emergency, remember RICE. R.I.C.E. is an acronym for Rest, Ice, Compression, and Elevation.
Each individual’s situation is different and may require specific advice on applying ice and heat. IF you have questions please contact one of our chiropractors and they will be happy to help.
Reference:
Watson, Tim (2008) Electrotherapy: Evidence based practice 12th Ed., Elsevier, ch 9. Heat and cold application.
