HEAT vs. ICE
Ice packs and heat pads are among the most commonly used treatments in orthopedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last?
HEAT: Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as over-use injuries, before participating in activities. Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns (20 minutes). Never leave heating pads or towels on for extended periods of time, or while sleeping.
Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48-72 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury. Ice packs are often used after injuries, such as when a sprain/strain has occurred. Applying ice early and often (20 minutes per treatment) for the first 48-72 hours will help minimize swelling which will, in turn, help to control the pain. Ice treatments may also be used for chronic conditions, such as over-use injuries. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity (heat is protocol for that).
Application of HEAT & ICE: Application of either ice or heat should never be longer than 20 minutes to reduce risk of burning skin, as the skin can be burned/damaged from both ice and heat therapies if used improperly. Also, direct heat or cold should never be applied directly to the skin, there should always be some form of buffer between the two (towel or cloth). Also, my personal preference (what I recommend to my patients) is once an injury has gone past 72 hours and is considered a chronic injury heat and ice should be applied alternately, always ending in ice. For example, 20 minutes of heat then 20 minutes of ice, one right after the other, always ending with ice. So without getting technical, the way I look at it is the heat speeds things up and allows more blood and lymph flow to the injury, which speeds up the healing process. Ice, however, slows everything down and decreases the amount of blood and lymph in the injured area, but also decreases swelling & inflammation (responsible for pain). So think of it as a pump, heat pumps the good stuff in and ice pumps the bad stuff out before it pools and starts to swell and become inflamed. Also, as mentioned above if it is an over-use injury, heat before activity to loosen/warm muscles up and ice after activity to reduce inflammation/swelling, therefore reducing pain.