We hear it almost daily in the office. Patients come in with a new pain or new injury and tell us they have used heat, many of them almost constantly, to try to relieve pain. When asked if it helped, the usual reply is “not really.”The problem: Most people do not know when to use ice or heat on an injured or painful area.Many people automatically think the use of heat will ease the pain or discomfort they are experiencing. But, it is important to note that ice and heat have opposite effects when it comes to dealing with pain and inflammation.Ice should be used immediately following an injury because it constricts blood vessels, which in turn decreases the blood flow to the area; thereby, reducing the heat and swelling associated with inflammation. It can also numb pain. Decreasing swelling around an injury will help to control the pain.Heat increases local blood circulation, relaxes tight muscles and promotes healing.Ice should be used within the first 48 to 72 hours. It is during this acute stage that pain, tenderness, bruising and stiffness most commonly occur. Ice should be applied for 20 minutes maximum, with approximately one hour between icing sessions, to give the skin time to return to a normal temperature before reapplying ice therapy. Never apply ice directly to the skin, always use a light towel like a paper towel or light dish towel to wrap the ice pack in.Heat should not be applied at this stage. Because it increases blood flow to an area; thereby, increasing blood leakage to the tissues, applying heat can increase swelling and possibly add to the pain.The point when inflammation decreases, even though pain and stiffness may still be present, is usually referred to as a chronic stage. This normally occurs about 72 hours after the injury. Both heat and ice may be used at this time to contribute to the healing process.Heat may be used to relieve muscle tightness and joint stiffness. Heat increases blood flow to the injured area and warms it. When using heat, apply moist heat, not dry (this means no heating pads). A hot, wet towel is a great source of moist heat. Moist heat can also help to decrease chronic muscle spasms. Therefore, heat may be good to use before a workout or before activity involving the injured or painful area. Do not use heat after activity.When using heat, it should be applied no longer than 20 minutes at a time, with approximately an hour in between sessions. You can continue to use ice at this stage to control pain and swelling that may still occur at times. Do not ice an area before activity, but the use of ice post-activity will help control the inflammatory response. It also can be used for joint swelling due to inflammatory arthritis.If in doubt, you’ll never go wrong if you use ice on an ache or pain, but using heat instead may actually slow the healing process.Palmer Chiropractic494-1395www.palmer-chiropractic.com
