by Martina James — Sports Massage Therapist, Physical Therapist
I’ve been a massage therapist for 7 years and was a Physical Therapist prior to that in Germany. One of the most common questions I get asked regarding injury repair is ICE or HEAT? An easy answer would be to use heat for chronic pain and ice for acute pain, but this isn’t the complete answer. I’ll try to clarify here.

Acute pain is easier to figure out. Most acute pain arises from a fall, twist or collision and is almost always accompanied by signs of inflammation.

Signs of Inflammation:

  • Warm to touch
  • Redness
  • Swelling
  • Pain
  • Loss of function

In most cases of acute injury you could use the RICE acronym to remember your best course of action.

RICE stands for:

  • R – Rest
  • I – Ice
  • C – Compression (ace bandage etc…)
  • E – Elevation

“I” is for ice. So ice your acute pain usually for the first 72 hours.

Icing in itself needs some explanation here. Ice causes a vaso-constriction (narrowing of blood vessels) which helps minimize internal bleeding at the injury site, prevents swelling, and relieves pain.  When icing injuries, you should ice for 15-20 minutes, 3 to 4 times a day. The body takes about twice as long to thaw as it does to freeze. So if you iced for 20 minutes wait 40 minutes before re-icing. Also, avoid ice packs and frozen food if possible. Instead, use ice in a plastic bag or a hot/cold water bottle.

A Few Tips About Icing

If you use the hot/cold water bottle (some are called ice bags – basically made out of thick rubber), add a tablespoon of isopropyl alcohol and then put the bag back in the freezer after use. When it freezes, the ice won’t stick to itself. It will freeze with a crunchy/squishy consistency, making the bag pliable the next usage. This bag can be placed directly on the skin.

A plastic bag filled with ice works well too. You can also place this on the skin.

If using an ice pack, don’t put the bag directly on the skin – lay a piece of paper down between the bag and skin. Many ice packs can burn you they make direct contact with your skin.

Chronic Pain

Conversely, chronic pain lasts longer than the 72-hour period of acute pain and usually doesn’t have the 5 signs of inflammation. Chronic pain is slow to develop, comes and goes, is often described as a dull pain or as soreness, and is usually the result of either an acute injury that didn’t heal properly or a repetitive motion disorder. When chronic pain is accompanied by inflammation – ICE.

Otherwise heat is your best bet.

Warmth increases circulation and metabolism and helps muscles to loosen, which is exactly what the body needs to regenerate and heal.  For all of those people who have shoulder and back pain after a long day at work (repetitive motion and/or bad posture) try taking a 20 minute warm bath to help alleviate the pain. Heating pads work as well.

A product called ThermaCare Heat Wrap provides a mild heat for 8 hours. Psoas sells these or you can pick them up at Walgreen’s or Target.

If you are injured please call to make an appointment or give a buzz if you are still unsure whether to heat or ice–we’ll let you know our thoughts.

Courtesy of http://www.psoasbodywork.com