To Your Health
July, 2008 (Vol. 02, Issue 07)
Hot or Cold: Which Is Better When Treating an Injury?
For an answer to this often-asked question, let's hear what Dr. Jessica Heller, a chiropractor and certified strength and conditioning specialist in Wisconsin, has to say:
Both heat and ice improve healing by manipulating blood flow, reducing inflammation and reducing pain. Knowing which one to use when, though, will keep you from possibly doing further damage.
Cold Treatment: Ice should be used on acute injuries (injuries that have occurred within the last 72 hours). [The] aim is to limit the body's response to the injury. It does this by reducing further bleeding into the injured tissues, preventing or reducing swelling, and reducing muscle spasm and pain. Ice should also be used for chronic conditions (arthritis, tendonitis, overuse injuries in athletes), but after activity. This will help control the inflammatory response.
There are several methods for icing an injury. The first uses an ice pack. Place a thin layer of cloth over the injury to avoid frostbite. Place the ice pack over the cloth. Leave the ice on for 20 minutes. It is normal to go through the phases of cold, burning, and then numbness. Do not leave the ice on for more than 20 minutes, or you can do more harm than good. Ideally, ice on an acute injury should be applied every 2-3 hours.
Heat Treatment: Heat should be used for chronic injuries to relax and loosen the tissues and stimulate blood flow to the area. Heat should be used before activities, not after. Do not use heat after an acute injury. It will increase bleeding and make the problem worse.
Moist hot towels are the most effective form of heat treatment. They are more effective because the moisture keeps the area from drying out and becoming brittle. Place a washcloth under hot tap water, or heat it up slightly in the microwave, and then apply it directly to the injured area. Heating pads will also work, as well as hot water bottles and soaking in a hot bath. Do not apply for more than 20 minutes at a time. Never fall asleep on a heating pad, and do not apply body weight to the heating pad (do not sit or lie on it).
Combination Therapy: 48-72 hours after an injury, you can also use combination therapy to get the most benefit from both heat and ice. To do this, alternate hot and cold packs for 10 minutes each. By alternating, you keep the swelling under check with the ice, and keep blood and its nutrients circulating through the area with the heat. Be sure to always end with ice, so that the heat does not contribute to further swelling.
Resource: "Heat vs. Ice." Ezine Articles, accessed June 4, 2008.
Bear in mind that hot and cold packs aren't the only ways to promote healing following an injury. Your doctor can provide more information and help determine which type of therapy is right for your specific condition.
Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore. He is a nationally recognized expert in treating tailbone, sacroiliac and lower back pain.