SHOULD I ICE, HEAT, BOTH?

 There are so many questions surrounding the use of ice and heat and when to do what. This has been a very controversial topic for a long time. 

Let’s start with this, both heat and ice have about the same level of effect depending on the situation. And BOTH offer only mild analgesic benefits. Ice and Heat are not going to fix or heal injuries, however they are cheap, easy, and accessible for people to use and apply at home. In the same way that both may provide minor relief and improvement, both may also cause minor harm.

ICE:

The controversy of icing has been a big topic lately and there is a lot of good logic to support the idea that icing is not the go to answer anymore. When an injury occurs our body’s initial response is through the inflammatory process. Think of a fever for example, the increased body temperature is the body’s tactic to kill off the virus infecting us. With a sprained ankle, the area initially swells. During this initial swelling phase, inflammatory cells and fibroblast come to the injured area to initiate tissue healing to the damaged cells. This is a necessary and crucial phase of the healing process.

Everyone says you should ice to reduce inflammation. Is ice actually reducing the inflammation? No! It is actually slowly the body’s ability to kickstart the healing process and to remove the inflammation effectively. The lymphatic system is the natural process for removing inflammation from an area and icing can actually slow that process.

So why use ice at all? Ice does have a mild analgesic effect which can reduce the pain enough to allow for activity, which is also recommended. If you are using ice to reduce pain it can be beneficial for you. We recommend application not exceed 20 minutes at a time.

HEAT:

Heat is often used to help relax muscles, reduce chronic pain, and relieve aching and stiffness. Applying a comfortable amount of heat can help to soothe the painful area. Heat also provides an overall relaxing effect to an area which can help to decrease muscle tension caused by factors not associated with an injury (i.e. stress). 

Similarly to ice, there are also times where heat may do more harm than good. In the case of acute muscle spasm heat can actually cause setbacks. When you experience a low back spasm, your body is guarding as a natural protective mechanism (much like the inflammatory process and fever process). Using heat to relax the muscles may be too effective and cause an increase in muscle tension and spasm. When you get up to move around immediately following the application of heat your body may reactively go into increased spasm and cause increased pain.  Another scenario in which to avoid applying heat is when there is overt swelling, like with the ankle sprain. Heat in this case will likely cause increased pain and aggravation to the area.

SO NOW WHAT?

Both ice and have have minor effects on both improvement and harm. Generally for pain relief we recommend patient preference for which one reduces pain, allowing you to do your recommended activities. In the case of acute injury it may be best to let the body do what it does best, naturally.