Painful Injury: HEAT or ICE?

You have just sprained or strained a muscle and are not sure whether to use heat or ice to alleviate the pain.

Ice

When an injury occurs, swelling develops almost immediately and persists for about 48 hours. Use ice as soon as possible to stop the swelling and to minimize the pain. Apply ice for 10 to 20 minutes every 2 to 3 hours while awake. Be careful not to apply it directly on the skin (prevent frostbite), and do not exceed the recommended application time. Do not apply heat at this stage. Because of its cooling effect, ice reduces blood flow to the injured area, reduces swelling, and numbs pain, thereby limiting tissue damage and bleeding risk. Regular ice works very well and there are synthetic substances available as well. Simply place a few whole or crushed ice cubes in a plastic bag and wrap in a wet towel. Apply the ice to the injured area. If there is a significant amount of swelling, it may help to apply a pressure bandage and elevate the affected limb above the heart.

Caution: Ice is not recommended if you have circulation problems, anemia, Raynaud's disease or syndrome (abnormal closure of the blood vessels in response to cold), an open or infected sore, or cold urticaria.

Heat

Swelling usually stabilizes after about two days. The body then works to repair the damaged tissue and reduce the swelling. At this point, or later, if inflammation persists, apply heat to the injured area, since heat activates blood flow, facilitates the healing process, and relieves pain. Apply heat for 15 to 30 minutes, 4 times a day. Moist heat is preferable (e.g., hot water bottle). Protect the skin from burns by wrapping the hot water bottle in a towel.

Caution: Heat is not recommended if you have circulation problems, bleeding, an open or infected sore or a cancerous tumor in the area where the heat is to be applied.

Who to see and when to seek medical advice

Consult a healthcare professional (doctor, physiotherapist) if:

  • The measures above do not provide relief;
  • Pain increases;
  • Loss of mobility in the affected area;
  • Pain is disrupting sleep;
  • Rest has not helped improve the situation.

"Use this information wisely and always exercise caution!"

For more information:

Canadian Physiotherapy Association

www.physiotherapy.ca

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