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HEAT VS ICE – WHEN AND WHAT TO USE

July 24, 2013

Bonnie Platt DSC00584Perhaps you wake up one morning and your neck is stiff and sore; or you overdo it playing touch football with your son and your knee is painful and swollen.  If you decide to treat a condition or injury like this at home before calling the doctor, you might be confused as to which method – heat or ice – is appropriate. 

Physical therapist  Bonnie Platt of Masonicare’s Outpatient Rehabilitation Department offers some sound advice to help us determine when heat or ice should be used and hopefully, avoid a trip to the doctor’s office. 

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As we all know, sustaining an injury can often interfere with our daily activities and lifestyle. With a better understanding of the injury and the proper treatment to use, we can get back in the game quickly. 

To put it simply, heat is best for chronic and long-standing problems, such as arthritis and stiff backs, while ice should be used for acute injuries, such as a sprained ankle or following a fall.  Unfortunately, most of us don’t understand the difference between acute and chronic so we self-treat with whatever we think feels good. It’s important to know the difference, however, because the proper use of either ice or heat at the right time will definitely speed up the recovery process.

 Should I apply heat or ice for my stiff muscles when I get up in the morning?

 Heat treatment relieves stiffness and chronic aches, facilitates relaxation, and stimulates circulation. It works by increasing tissue temperatures and blood flow, thereby drawing extra nutrients into the area to assist in the recovery and healing process. Typically, chronic injuries have some sort of ischemia (lack of blood) associated with them. The ischemia is detrimental to healing and the moist heat helps reduce it.

 For how long should the heat be applied?

 Heat is usually applied for about 20 minutes.  Always place multiple towels between the body and the heat to prevent trauma to the skin.  Heat should never be used on acute injuries until the swelling is controlled. The heat will initially feel good, even though it is adding inflammation and swelling. However, once the heat is removed, the injury site is usually more irritated than if you had left it alone. Heat draws fluids into tissues and can increase swelling and inflammation. Do not use heat over swollen tissues or where there is redness.

 Why should I use ice on an acute injury?

 When applied immediately after an injury, cold reduces tissue damage by reducing the blood flow, reducing the metabolic rate and decreasing the production of metabolites and metabolic heat which result from the body’s inflammatory response to the injury.  This helps reduce bruising, swelling and discomfort. As the muscle warms and the blood vessels expand, new blood comes rushing in and cleans the debris left behind from the injury and stimulates the healing process. Cold also relieves muscle spasms, reduces post-exercise soreness, and stimulates circulation in areas of chronic discomfort.

 For how long should the ice be applied?

Cold is usually applied for about 10 to 20 minutes. There are four stages of cold treatment: The first stage is an uncomfortable feeling; the second stage is a stinging sensation; the third stage is burning or aching; the fourth stage is numbness. It takes five to fifteen minutes to reach all four stages. To reduce post-exercise soreness, apply cold immediately after exercise for about 10 to 20 minutes. For chronic discomfort, apply cold for a minimum of 10 minutes. Some people keep the cold on for more than 20 minutes, but increasing the icing time has a negative effect on the body. It starts to act like heat and increases blood flow to the area.

If you’ve experienced a minor injury that needs more than self-help at home, or you require outpatient therapy for a more serious injury or to help recover after major  surgery, the skilled and sensitive professionals with Masonicare’s Outpatient Rehabilitation Services are here for you.  They’ll create a customized treatment program and coach you with healing exercises, problem-solving skills and self-care information.  A physician referral is required, and Medicare, workers compensation and most commercial insurances are accepted.  The department is conveniently located in the Medical Office Building on the Masonicare campus in Wallingford.  Simply call 203-679-6909 for additional information or a consultation.