This is a question I get asked all the time: should I use heat or ice for my injury? When used properly, hot and cold therapy help to control swelling and inflammation, reduce pain, promote tissue healing, and increase flexibility.
COLD THERAPY
Cooling agents (ice/cold packs, ice baths, ice cubes, crushed ice compresses, cold cloths) are used to reduce swelling and inflammation by causing blood vessels to narrow, thus decreasing blood flow. They play an important role in pain management as well by creating an analgesic or numbing effect on the affected part of the body. They are typically applied after an acute injury (within the first 24 to 48 hours) to prevent excessive tissue damage. After such injury, follow the "POLICE" protocol to reduce pain and swelling: Protect, Optimal Load, Ice, Compress, and Elevate. Cold therapy can be continued after the first 48 hours if inflammation persists (red, swollen, hot, painful). Cold may also be used after exercising to reduce muscle soreness and ease muscle spasms. Cold therapy may be applied periodically throughout the day for approximately 10 to 15 minutes at a time. Check the area being treated regularly for changes in skin colour.
Cold therapy is generally not indicated for people with the following:
Impaired circulation or sensation
Hypersensitivity or intolerance to cold (Raynaud's disease)
Over open wounds, areas of infection, or irritated skin
Over nerves
HOT THERAPY
Heat promotes healing by causing blood vessels to dilate, thus increasing blood flow and nutrients while removing cellular wastes from the affected area. Heating agents are often used for chronic injuries or before exercising to decrease muscle tightness and increase flexibility. They are useful in managing pain, reducing muscle tension and spasms, and decreasing joint stiffness. However, heat should be avoided when an injury is in its acute phase (red, swollen, hot, painful). Heat can be dry (electric pads, hot water bottles, gel packs) or moist (damp clay packs, damp/steamed hot towels, hot baths, hot tubs, saunas, steam baths). Moist heat is preferred as it penetrates deeper into the body. Heat therapy should be applied for 15 to 20 minutes at a time. Check the skin regularly to ensure there are no abnormal changes in skin colour. Do not lie on top of a heating pad when going to sleep as it increases the likelihood of burns.
Hot therapy is generally not indicated for people with the following:
Impaired circulation or sensation
Areas of recent bleeding or bruising
Over open wounds, areas of infection, or irritated skin
Cancer
Acute injury or inflammation
During pregnancy (locally)
*It is important to layer a towel between the skin and the ice or heat. Towels are used as barriers to prevent skin irritations, burns, and frostbites. It sounds like common sense, but I've seen some pretty bad burns from people putting something directly onto their skin!
