Daily Tips and Advice
Should I use Ice or Heat on my Injury?
Posted 3 years ago
Should I use Ice or Heat on my Injury?
I was asked this question this week in clinic. In fact, I'm always asked this question so I was prompted to write this;
The patient asked me:
"Stuart should I be using heat or cold on this back pain of mine? I don't know what to do for the best, and I don't want to make things worse"
This really is one of the most frequent questions that I get asked in Physio, so, I thought that I should try to explain a little more.
The general rule of thumb is...
That with a new or very recent traumatic sports injury, 'domestic' injury or trauma caused by recent surgery (that's the damage caused by the surgeon going to town on you with scalpels, cutting tools and hammers-for all the right reasons of course). That you should be using....
Ice or cold as a method of easing pain and swelling in the first instance.
Think of it like this...
If you sprain a knee or ankle and have knee pain or ankle pain then things tend to get
big red, hot and painful right?
But why are things swollen and red and painful?
When you suffer a sports injury such as the sprained ankle, sprained knee or sprained back, what's actually happened is that you have suffered internal damage to the soft tissues (muscles, tendons, and ligaments) that surround the joint or area.
Basically, you have just torn these structures to some extent.
A lot like when tearing skin (cutting yourself), internally you also get the associated bleeding, but you can't directly see the blood and other tissue fluids pouring out. What you are aware of is the redness and swelling of the outpouring of blood and tissue fluid, and some days later that clotted blood is obvious in the form of a bruise.
Cold and ice would be used in this case to reduce the heat and redness of the sports injury. This is essentially the first part of Physiotherapy treatment that you could perform on yourself for the affected body part. Think about what you see on TV when the Physio takes the injured player from the pitch. They wrap the relevant body part whether its a back or leg or arm injury in bags of ice.
You are essentially looking to 'dampen' the heat by conducting the it away from the area or body part and into the ice-that's why your ice pack or bag of peas ends up melting! We are trying to limit the internal bleeding by forcing the blood vessels to squeeze tighter and reduce blood flow in response to cold. Think about how you shy away from really cold surfaces, the same thing happens to blood vessels.
The absolute opposite of this would be to add heat to the area. That's just like fighting fire with fire-not a good thing when you think about calming down a sports injury. By adding heat you encourage swelling, heat, redness and overall bleeding! Not good.
So what about back pain and hot and cold therapy? And where does the use of heat come into all of this?
Let's talk about back pain first.
What lots of people don't realise is that when you have an acute or new back pain as the result of an injury, sporting or not is that the same process of tissue damage as discussed above that occurs. It's just that with the back you tend not to get the hugely noticeable swelling! All the internal damage is still there. So treat it the same.
So with the new onset of back pain you first need to calm the situation of bleeding, and swelling. So apply the cold, the ice pack or the bag of peas to the area. You may apply the cold for 15-20 mins every 2 hrs or so.
Just don't make the body part so numb that you cause yourself an ice burn-it does happen! To protect the skin, have your ice pack wrapped in a cold tea towel.
The initial swelling and tissue bleeding continues for approximately 72 hrs after a sports injury. So continue as able to ice every 2 hrs or so. But please note that swelling may well last a lot longer than 72 hrs so ice as required.
If you only ice for 24 hrs after a sports injury it's better than not icing at all.
So what about using heat for a sports injury or back pain?
Well that's another article of its own
See Part 2 next week.
PS - If you find this information useful and know someone else who might make use of it, please share the link or the info. Thanks