Ice or heat?

Ice or heat? I’m asked this question a lot and there is no blanket answer. Each injury is unique and requires a unique treatment protocol.

Having said that, here are some basic rules of thumb:

1. Cold therapy works best for immediate treatment for acute injuries because it reduces swelling and pain.  It can also be used for chronic tendonitis or strains. (Ice the tendons and ligaments and not the muscle belly).
2. Ice for 15-20 minutes and then wait another 45 minutes before applying ice again. In this case, more is not better, and icing for longer than 20 minutes can cause an increase in inflammation (known as the huntington’s response).
3. The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced, but frozen peas will work.
4. Heat is generally used for chronic injuries or injuries that have no inflammation or swelling.
5. Heat is useful for muscle aches and tightness.
6. Safely apply heat to an injury for 15 to 20 minutes at a time.  Have enough layers between your skin and the heating source to prevent burns.
7. Heat before activities and ice afterward.
8. Heat at the beginning of the day and ice in the evening before bed.

Some words of caution: heat can cause the blood vessels to open up more and cause an increase in inflammation.  Do not use heat for injuries where inflammation is apparent.  This is why when people use heat on acute injuries they will be more stiff on the following day.

As always, check with your chiropractor regarding your specific injury

-Dr Jerry

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