Should I use heat or ice on my injury?

Caution: ice and heat therapy can both interfere with circulation, especially in the elderly, the immune-compromised, and those with circulatory problems or who suffer from serious disease (including cancer). When in doubt, check with your physician. Never use any form of ice or heat therapy unless you are certain it's appropriate for you to do so.

Ice

Best when on an acute injury (sports injury, sprained joint, fall or other impact, whiplash from a car accident) has resulted in acute inflammation in the area of injury.

Signs of acute inflammation include:

• visible swelling or swelling that you can detect with your fingers
• redness or other signs of irritation
• a change in skin temperature, usually with the affected area feeling warmer than the surrounding areas

Ice helps to:

• reduce swelling and inflammation
• reduce redness and irritation
• reduce pain

In general, ice is appropriate for acute stage care, but listen to your body! If ice seems ineffective, or if you feel worse after 5-10 minutes, discontinue use and consult your physician.

Using Ice Safely

When possible, use frozen gel packs for ice therapy. These commercial products reduce the risk of a too-cold pack interfering with circulation. Wrap the pack in a towel and apply it to the injured or painful area. If your gel pack is cloth covered, you may apply it directly (a damp towel increases the effectiveness of the ice). If frost is visible on it, however, use even the cloth covered pack over clothing, or wrap it in a towel. You can expect to feel a little cold discomfort in the area before any numbness or pain reduction has taken place. Limit your gel pack to 15 minute sessions.
If you must use ice (e.g., bag, compress, direct massage) take care to avoid skin or circulation damage. When using an ice bag, protect exposed skin with a towel or take steps to ensure the ice bag is moved regularly. Never use ice for more than 10-15 minutes in one session. Limit ice massage to 5 minutes.

Heat

Best when you must cope with chronically stiff muscles or joints, or if your pain increases as the weather becomes colder. Heat helps to:

• increase circulation to the affected area
• bring fresh nutrients to an area that is healing
• relax chronically stiff muscles and joints to improve function

Using Heat Safely

Persons with circulation problems should use neither hear nor ice because they can't reliably tell if the area is warming or cooling properly. Wrap hot packs in four to eight layers of thick toweling to start with. Adjust towel thickness as needed, but take care -- heat accumulates quickly and what seemed too cool to start with can warm up in a hurry. Always use caution.
In general, you may heat commercial hot packs in either boiling water or the microwave. Microwavable packs can be safer to handle in this regard, but you must warm them gradually. Follow the instructions that come with the pack (or from your physician). Warming a too-cool pain in increments is easier and safer than experimenting as a too-hot pack cools down.
A safe way to use heat is in the form of a simple compress heated in warm (not hot) water. Or soak in a warm bath, or let a warm shower run directly on the area. Regardless of the method you choose, limit heat therapy sessions to 15 minutes.
As for heating pads, the best advise is to not use them. Heating pads can overheat quickly and burn you before you know what is happening. Electrical wiring can short out. There are safer and easier ways to apply heat. I urge you again -- don't use electrical heating pads for any reason.

Alternating Heat and Ice

The theory behind combination (or contrast) therapy is that alternating cold and hot stimulates circulation. Ice drives blood and fluids out, and heat draws them in, creating a pumping action in the tissues which, in turn, promotes healing. You should use combination therapy only when your physician recommends it for a specific ailment.

Remember - Before using either heat or ice therapy, consult your physician.