Ice vs. Heat…. You may be Using it Incorrectly

I get a lot of patients who come into my office when they have injured their body and I often ask them if he/she applied ice or heat to help with the pain.  The most common answers include, “I only used heat”,  “I alternated between ice and heat”, or “I didn’t know which one to use”.  This blog will hopefully dispel the myths between when to use ice and when to use heat accordingly for injuries suffered.
Ice, is typically used for acute injuries, meaning that it is a brand new injury or an old injury that has flared up.  Ice helps to decrease swelling, inflammation, and to numb the area.  When applying ice to the skin, there are 4 phases of cold which one experiences once cold touches the skin (CBAN: Cold, Burning, Achy, and Numb).  This implies what the person will feel as they apply ice to their injury over a period of a few minutes.  Typically, ice should be used for the first 72-96 hours for the 2 types of injuries listed in the 1st sentence of this paragraph.  Heat, although it feels good when applied, actually worsens the injury by creating more inflammation and pain when it is removed, thus delaying your healing.
Heat, is typically used for injuries greater than 72 or 96 hours, or chronic injuries.  Heat helps to increase blood flow, circulation, and carry away inflammatory chemicals by way of your white blood cells (the body’s immune cells) from an injured tissue.  The inflammatory process in your body takes about 3-4 days with an injury to help the body begin the healing process.
It is important to note that when using either ice or heat, you must ALWAYS apply a barrier (towel, clothing, etc…) to your skin to avoid burning your skin (you can actually obtain a 2nd degree burn from direct ice or heat!).  Also, to avoid applying ice or heat for no more than 20 minutes.  More often than not, I have patients who sleep with the heating pads on or leave it on there for hours.  This is a big NO-NO because of burning the skin.  I know the heat or ice may feel good, but going no more than 20 minutes with a barrier ensures proper application and a decreased risk of further injury.
After reading this, if you still aren’t sure when to ice or heat now, ask your local healthcare professional or call my office and I can clear this up.  Stay tuned to next month’s blog!

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