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Ice or Heat?
Dr. Don Parkerson, Jr.
This may be the #1 question
that I hear from patients. One feels
good at the time, but you’ve always heard that the other is really best. The truth is that there are certain
situations where each of these treatments is most effective. Here is a quick guide to help you know
whether to use ice or heat.
Acute vs. Chronic
First, you must know the
difference between acute and chronic pain.
Acute pains are those that are sudden, sharp, and intense with a rapid
onset and possibly severe pain.
Typically, acute injuries result from some sort of trauma, such as an
auto accident, fall, or lifting injury.
Acute injuries are usually
easy to identify because of the sudden onset.
Other than the obvious pain, signs and symptoms include swelling and
inflammation. If you have any type of
swelling, you have an acute injury.
A typical scenario would be a pain-free patient
bending and lifting a box of files at work, and then suddenly experiencing
extreme, intense pain. Similar problems
often develop from any of the following as well:
·
Playing golf
·
Bending and
lifting children or grandchildren
·
Picking up heavy
laundry baskets
Chronic problems are slower to
develop, can come and go, and may cause dull pain or soreness. They are often the result of overuse or
overwork to that part of the body, but can develop when an acute problem is
left untreated.
When should I use ice?
Always use ice after an acute injury. As stated before, acute injuries will usually
show signs of swelling and inflammation, both of which respond best to
ice. Cold therapy, or cryotherapy, constricts the blood vessels, which reduces
blood flow to the injured area and prevents swelling.
The benefits of using ice on a
back or neck problem:
·
reduced pain
·
reduced
inflammation and swelling
·
reduced muscle
spasm
In our clinic, we recommend
that our patients use this icing regiment:
·
Apply the cold
treatment for 20 minutes. Remove it for
20 minutes. Re-apply for another 20
minutes and remove for a period of 2-3 hours.
·
Repeat cycle
throughout your waking hours for 2-3 days.
You may also find that ice is
effective on chronic problems such as chronic lower back pain, neck pain, or
arthritis. After the pain is no longer
acute, a simple trial and error test will usually clearly indicate whether your
chronic problem will respond well to ice.
What type of ice do I
use?
When choosing an ice
treatment, you have many options. Among
the simplest are the following:
1.
Commercial cold pack – these are readily available in
all shapes, sizes, and price ranges. We
sell the blue gel types in our clinic, but any of them will work fine.
2.
Ice pack – put
about 1 lb of ice in a plastic bag and add a little water to the ice so that it
will conform to your body. Then, squeeze
the air out of the bag and seal it. Wrap
the bag in a wet towel and apply it to your affected area.
3.
Ice towel – wet
a towel with cold water, and squeeze it until it is just damp. Fold the towel, place it in a plastic bag,
and freeze it for 15 minutes. Remove the
towel and place it on affected area.
4.
Bag of frozen
vegetables – you may laugh, but a bag of frozen peas will work just fine, too.
Icing Precautions:
1.
Do not apply directly
to the skin. Place a light towel between
the skin and cold pack to avoid skin burn.
2.
Children and
elderly patients have a lower tolerance to cold and may need to apply for
shorter periods of time.
3.
Do not use cold
therapy if you have circulatory problems.
4.
Never use ice for more
than 20 minutes per treatment or while sleeping.
When should I use heat?
Heat is most effective for chronic problems that seem
to last for longer periods of time. A
nagging back problem, or a persistent muscle spasm
would be good indications for the conservative use of heat.
Heat stimulates and
increases blood flow to the injured area. In addition to promoting healing,
heat also relaxes muscles and eases pain.
Indications for the use of heat include the following:
·
Chronic muscle
spasm
·
Chronic back
stiffness
·
Joint Stiffness
If you choose to use heat, do
so only in intervals of 15-20 minutes throughout the day. Do not use heat for more than 20 minutes per
time.
You may also find that alternating
treatments of ice and heat can be effective in some cases of chronic pain. The idea there is to add the muscle
relaxation effects of heat to the swelling reduction of ice.
What type of heat do I
use?
Heat treatments can be
accomplished in several ways:
Moist heat – usually the most effective type
of heat.
·
Hot bath or
shower
·
Hot, wet towel
wrapped around the affected area
- Electric heating pad – if you choose this
option, don’t fall asleep while the pad is on and always use the heating
pad at low or medium settings.
- Microwaveable heat pack – these nifty
inventions, like the one to the right, can often be used as either hot
or cold packs.
Heat Precautions:
1.
Never use heat
on an acute injury or any injury that shows signs of inflammation and/or
swelling.
2.
Do not apply
directly to the skin. Place a light
towel between the skin and heat to avoid skin burn.
3.
Never use heat
for more than 20 minutes per treatment or while sleeping.
4.
When using heat,
be very careful to use a moderate degree of heat for a limited time.
5.
Do not apply
heat after exercise
|
Ice or Heat? |
Ice |
Heat |
|
When To Use |
After an acute
injury, or after activities that irritate a chronic injury |
Only on chronic
problems or persistent muscle spasm |
|
How To Apply |
Use an ice pack,
frozen towel, or frozen vegetables |
Use moist heat, a
heating pad, or microwaveable heat pack |
|
For How Long |
20 min on - 20 min
off - 20 min on Then wait 2-3 hours
and repeat |
No more 20 minutes
at a time and never while sleeping |
For further information on this topic, you may contact
Dr. Parkerson at 770.952.5353, by email at Parkerson@humberparkerson.com,
or visit our clinic on the web at www.HumberParkerson.com.
The Highest Level is the monthly e-mail newsletter of
the
© Humber Parkerson Clinic 2006
November 2006 issue of The Highest
Level
