Ice Ice Baby

To ice or not to ice. That is the question.

We treat everything from arthritis to pulled muscles to inflammation with ice packs or heating pads. Treating pain with hot and cold can be extremely effective for a number of different conditions and injuries, and easily affordable. The tricky part is knowing what situations call for hot, and which call for cold. Or both. As a general rule of thumb, use ice for acute injuries or pain, along with inflammation and swelling. Use heat for muscle pain or stiffness.

ICE THERAPY
Ice therapy, or cryotherapy, works by reducing blood flow to a particular area, which can significantly reduce inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain. According to primary care sports medicine physician Anne Rex, DO, “…Ice wins to shut down swelling, inflammation, and pain early on where heat may actually make an injury worse.” Common issues that require ice therapy are acute injuries (less than 6 weeks old) such as: gout flare-ups, headaches, and tendinitis. You can also use cold treatment after exercise or activities to prevent any flare of inflammation. It is NOT recommended on stiff muscles or joints or if you have poor circulation.

Use cold therapy for short periods of time, several times a day. Ten to 15 minutes is fine, and no more than 20 minutes of cold therapy should be used at a time to prevent nerve, tissue, and skin damage.

HEAT THERAPY
Heat therapy works by improving circulation and blood flow to a particular area. The increased blood flow relaxes tight muscles and relieves aching joints, so heat is great for chronic muscle aches, pain that feels sore or achy, overuse injuries, and tendinosis— lingering injuries (older than 6 weeks). Increasing the temperature of the afflicted area even slightly can soothe discomfort, increase muscle flexibility, relax muscles, and heal damaged tissue. It is NOT recommended for people with certain pre-existing conditions such as diabetes, dermatitis, vascular diseases, deep vein thrombosis, or multiple sclerosis (MS), as there is a higher risk of burns or complications due to heat application.

Unlike cold therapy which has time limits, heat therapy is often most beneficial when used for a good amount of time; minor stiffness or tension can often be relieved with only 15 to 20 minutes of heat therapy, while moderate to severe pain can benefit from longer sessions lasting between 30 minutes and two hours.

CONTRASTING THERAPY
When does it make sense to use both ice and heat therapy? Ice and heat can both come in handy for treating an acute injury, but they should be used at different stages; you can use ice initially to reduce swelling and then, once the injury has mostly healed, heat can be used to soothe any remaining feelings of soreness. Likewise, if you have an overuse injury, both ice and heat can help manage the pain and keep the injury from worsening. In the case of overuse, apply heat to the injury before your physical activity, then use ice on the area after the physical activity.

Science has yet to firmly establish the effectiveness of heat and cold therapies, but neither treatment is very potent and the danger of an adverse reaction, when applied to a particular point on the body, is usually low. Individuals with chronic pain or a non-serious injury can try either method and find their own best solution.

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