Cryotherapy

ICE OR HEAT?

Unsure whether to use ice or heat?  How long should an ice or heat treatment?  

Some of the reasons why pain can be difficult to manage is the associated inflammation, pressure and swelling which often comes with an injury.  Ice can help reduce inflammation and numb the pain somewhat and is better used in acute situations - whereas heat helps to relax muscles and stiff joints and is mostly reserved for more chronic conditions. Ice helps reduce blood flow, thereby reducing inflammation and swelling.  Heat helps improve circulation and local blood flow thereby distributing more blood flow and oxygen to the tissues, which ultimately can speed up healing.

So which one is right and when should you use ice/heat?

Acute = ICE

Ice Pack

If you are suffering from a recent injury (acute) or muscle spasms, ice/cryotherapy is a good choice to help reduce swelling and to help reduce pain.  Ice or cold compresses reduce the temperature of the skin which constricts local blood vessels and may help limit swelling and in turn the local numbing from ice/cold compresses can help reduce pain.  While newer research has been mixed on the actual clinical applications of icing, if it feels good, keep doing it - but limit treatment with ice to 15-20 minutes per hour - meaning you don't want to keep icing continually as the local area needs some blood flow for the normal healing process to take place.  You can discontinue ice after the first 3 days but if it still feels after icing, you can continue to ice 15-20 minutes per time as needed.

Ice can also be used for chronic conditions, such as overuse or repetitive use injuries in athletes.  In this case, ice is applied to the injured area after activity to help control inflammation BUT you should avoid icing a chronic injury before activity. 

Always have a barrier between the ice pack and your skin.  If you are doing ice massage, keep the ice moving and limit this treatment to 8-10 minutes.


Chronic = Heat

Heat should be considered for chronic conditions to help relax tight muscles and relieve painful or achy joints.  This can be especially helpful to aid in improving range of motion.

In general, it is not recommended to use heat right after an activity, nor after an acute injury (see above for general icing recommendations). Remember the saying, “Warm up, cool down.” – The best sequence is to apply warm heat before an activity and ice afterwards.

Caution - Do not use heat where there is swelling —swelling is caused by bleeding in the tissue and heat just causes more blood to come to the area.  This will likely result in more pain and stiffness after the heat is removed. 

Heat Pack

Heating tissues can be accomplished using an electric heating pad but usually, moist heat is better (this can be accomplished at home with a hot, wet towel).  Be careful not to burn the skin - usually, moderate heat is better than higher temps.  Never leave heating pads or towels on for extended periods of time or while sleeping.  While heat can be used for a longer treatment period than ice (20-45 minutes with heat vs 15-20 minutes with ice), heat is still often effective within just 15-20 minutes.


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