Tuesday, April 30, 2013

To Ice or Not To Ice…That is the Question

Patients often ask “Which is better, ice or heat?”  The answer?  It really depends on the injury.

Ice should be used in acute injuries (injuries less than 72 hours old) to decrease pain and decrease tissue damage.  Ice causes vasoconstriction to decrease bleeding.   Ice does not decrease swelling that is already present, but will decrease any additional swelling.  It should be applied for twenty minutes, but not any longer.  Prolong application of ice can cause tissue damage.  Ice should not be applied directly to the skin.  Ice should also be used after surgery or cortisone injections.

For acute injuries less than 72 hours old the acronym RICE still applies:

R - rest the injured body part 
I - ice 
C - compression (like an ACE wrap)
E - elevate the injured area above heart level

Heat should be used for more long standing injuries and arthritis. Heat decreases joint stiffness, reduces pain, relieves muscle spasms and increases flexibility.  Never apply heat to open wounds or to a body part where there is loss or decrease in sensation (ex: peripheral neuropathy).  Heat should never be applied to an area where infection is suspected. 

When in doubt about whether to apply ice or heat, the best approach is to use ice until you can speak with your healthcare provider.

Did you know? 

-Frozen gel packs reach much lower temperatures than ice does, so do not apply directly to skin.

-People can be allergic to cold and react with hives, joint pain, and swelling.

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