It is widely known and accepted that the use of heat and ice can help to decrease pain but when is the use of one better than the other? When deciding whether to use heat or ice there are several variables that must be considered. *Disclaimer: It is recommended that you follow the instructions of your healthcare professional as they will be more aware of your personal health information.
The first thing you must consider is the acuity of the injury, or more simply stated, “When did the injury occur?” The use of ice is most appropriate during the first 72 hours of an injury. During this time there may be inflammation and swelling associated with the injury. If the affected area feels warm or the skin appears red, these are signs of inflammation and in this case ice should be used. However if you are suffering from a more long-standing injury (more than 2 weeks) it may be safe to use superficial heat.
The next thing to consider is how to apply the heat or ice. Crushed ice in a bag, ice and water in a bag, or frozen vegetables are the easiest and most affordable options for relieving inflammation and swelling. These methods are safe to apply directly to the skin, however if you cannot tolerate the cold you can use a thin barrier such as a pillow case or single ply paper towel. A hand towel or dish towel is often too thick to get the benefits of the ice. Re-usable ice packs are also great to use however you should avoid placing these directly on the skin without a barrier. This is because these re-usable gel packs freeze at a temperature lower than ice/water, which can actually burn your skin and possibly cause scarring or nerve damage.
When applying heat there are few options that are available for home use. The most common method is with the use of an electric heating pad. These are useful for relieving sore joints or an aching lower back but they really only heat the superficial tissues of the body. Another useful option is a hot/warm bath or shower. This is more effective for heating larger areas and allows the part being treated to be moved at the same time. The other benefit to the use of a bath or shower is that the heating effect penetrates deeper than a heating pad and is better for relieving pain associated with arthritis or muscle strains.
The last thing you need to know is how long and how frequently to use the heat or ice. Typical treatment times for superficial ice range from 15-20 minutes while heating can be applied slightly longer, up to about 30 minutes. It is recommended that you remove the heat or ice every 10 minutes to inspect the skin and make sure there are no abnormal signs such as increased swelling, blotching of the skin, hives or elevated patches, itching, or change in pigmentation of the skin. A common guideline for the frequency of use would be 1 time per hour with at least 45 minutes between sessions to allow the skin and underlying tissues to return to normal temperature.
If the use of ice or heat are not enough to reduce your pain or if you would like to speak with a licensed Doctor of Physical Therapy about your pain, please contact Hohman Rehab physical therapy, in Clermont and Ocoee.