You probably know by now how to treat an ankle sprain with the RICE method. But when else should you treat an injury with ice? And what about heat? Is it the right thing to apply for sharp lower back pain, and what about that niggling neck ache? To make sure you’re getting your temperature therapy right, read on. We’ll guide you through the ice versus heat decision, and help you recover sooner.
When to ice
Ice should be used for all acute injuries and when there is inflammation. Inflammation is a natural response of the body to a trauma or injury. By constricting the blood vessels, ice helps to reduce inflammation and tissue damage. It also acts as a local anaesthetic, numbing the soft tissues and slowing down the pain messages being transmitted to the brain.
When to use heat
On the other hand, heat can be beneficial for general muscle aches, joint stiffness, chronic pain, and stress. Heat increases blood flow which relaxes tight muscles and relieves aching joints. A heat pack or hot water bottle is also lovely and warming on a chilly morning!
What happens if you get it wrong?
Using heat in the acute stages of an injury will increase the pain and inflammation, which can delay healing. Ice should not be used on muscle cramps/spasm as it will only cause the muscle to contract further and cause more pain. If in doubt, speak to your physio.
Can you alternate ice and heat?
In some instances, yes. Alternating ice and heat has been shown to have some benefit in reducing exercise-induced muscle soreness. The ice works as an analgesic then the heat promotes blood flow to the affected area for faster recovery. Elite athletes will often use contrast water therapy (CWT), immersing themselves alternately in both cold and hot water.
How to use ice
The general rule for icing is ’20 minutes on and 20 minutes off’. Ice should be applied for the first 72 hours after an acute injury or trauma. It is important to make sure the ice pack is wrapped in a damp cloth (if it does not have a cover) to protect the skin from unpleasant ice burns.
How to use heat packs
Heat packs should be applied for 20 minutes up to 3-4 times per day. Single-use patches and wraps can be used continuously for up to 8 hours. If the heat pack is very warm, take care to avoid burning the skin by placing a towel between the pack and your skin.
When to avoid both ice and heat
Always avoid applying a hot or cold pack over an open would. And, if there is impaired sensation in the injured area, steer clear of both ice and heat and book an appointment with your physio.