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When you have an injury, it is often recommended as an easy treatment to heat, ice, or sometimes both! But it is not always so easy to figure out which modality is appropriate for your condition. Here are some tips to help decide which option is best for you.
If you have just been injured, it is referred to as being in the acute phase. This means that the body is trying to stimulate healing by increasing blood flow to the area. This influx of blood will cause a rise in heat, redness, and swelling in the area, known as inflammation. Inflammation is a normal biological process, but it causes irritation to the nerve endings in the area resulting in pain. ICE is a key treatment at this point in time to help minimize inflammation and pain. What does it do? Ice works by cooling the superficial layers of tissue, creating a numbing effect to the local nerve endings. It also causes blood vessels in the area to constrict, therefore slowing down blood flow and minimizing swelling to the area. Minimizing swelling can be very beneficial to prevent loss of function to the injured area as well as decreasing future pain from pressure aggravating nearby nerves. [Robertson et al, 2006] How often to ice? Try icing for approximately 10 to 15 minutes at a time, and allow the skin to return to normal temperature before applying again. Ice is the most beneficial in the first 24-72 hours post-injury. Ice can be applied using an icepack or bag of ice and wrapping it in a towel before applying to the injured area. Ice baths are also an effective way to quickly cool an area.
If you have persisting pain or sore and aching muscles, HEAT is likely your best bet. Heat can help to relax tense muscles and soothe local pain responses. What does it do? Heat works by warming the superficial layers of tissue, creating a calming effect to the local nerve endings. It also causes blood vessels in the area to dilate, therefore increasing blood flow to the area which can increase metabolism and stimulate tissue healing. It also helps by increasing tissue flexibility and reducing muscle spasm, allowing you to move the area through a greater range of motion. [Robertson et al, 2006] How often to heat? Try heating for approximately 15 to 20 minutes at a time, and allow the skin to return to normal temperature before applying again. Heat can be delivered by using a hot pack, a hot water bottle, heated blanket, or even a soak in a hot tub.
As both modalities are quite gentle forms of therapy, as well as having only mild effects of roughly equal value in recent studies, neither agent is superior to the other [Malanga et al, 2015; Garra et al, 2010]. In the end, it really just comes down to personal preference. If you try one and it does not have the desired effect, it is generally okay to give the other technique a try!
Robertson, V., Ward, A., Low, J., & Reed, A. (2006) Electrotherapy Explained (4th Ed). London, United Kingdom: Elsevier Health Sciences.
Malanga, G. A., Yan, N., Stark, J. (2015) Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine, 127(1), 57-65.
Garra, G., Singer, A. J., Leno, R., Taira, B. R., Gupta, N., Mathaikutty, B., & Thode, H. J. (2010) Heat or cold packs for neck and back strain: A randomized controlled trial of efficacy. Academic Emergency Medicine, 217(5), 484–9.
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