How Does Heat Reduce Pain
Heat is an effective and safe treatment for most aches and pains. Heat can be applied in the form of a wheat bag, heating pads, deep heat cream, hot water bottle or heat lamp.
Heat causes the blood vessels to open wide . This brings more blood into the area to stimulate healing of damaged tissues. It has a direct soothing effect and helps to relieve pain and spasm. It can also ease stiffness by making the tissues more supple.
If heat is applied to the skin it should not be hot gentle warmth will be enough. If excessive heat is applied there is a risk of burns and scalds. A towel can be placed between the heat source and the skin for protection. The skin must be checked at regular intervals.
Heat should not be used on a new injury. It will increase bleeding under the skin around the injured area and may make the problem worse. The exception to this is new-onset low back strains. A lot of the pain in this case is caused by muscle spasms rather than tissue damage, so heat is often helpful. A large-scale study suggested that heat treatment had a small helpful effect on how long pain and other symptoms go on for in short-term back pain. This effect was greater when heat treatment was combined with exercise.
Heat is often helpful for the following types of pain:
- Aching muscles from over-exertion.
- Aching pains from fibromyalgia and other chronic pain conditions.
- Cramping or spasm pains such as period pains.
When To Use Both Ice And Heat
In some cases, ice and heat can work together to help relieve pain. Alternating ice and heat is called contrasting therapy, and its especially common for arthritis patients. Ice helps reduce swelling and acute pain, and heat helps soothe stiff joints. If you have arthritis, you should work with your doctor to develop a treatment plan to manage your discomfort.
Ice and heat can both come in handy for treating an acute injury, but you should use them at different stages. You can use ice initially to reduce swelling and then, once the injury has mostly healed, use heat to soothe any remaining feelings of soreness. For example, one-third of people who sprain an ankle experience residual symptoms even after the injury has healed. If the symptom is swelling, ice is still best, but if its a dull ache or stiffness, heat can help bring some relief.
If you have an overuse injury, which is common for athletes, both ice and heat can help you manage the pain and keep the injury from worsening. In the case of overuse, apply heat to the injury before your physical activity, then use ice on the area after the physical activity.
What Ice Does To The Body
Before we look at when ice is the right way to treat an injury, its helpful to understand what ice does to your body. In short, ice can help reduce:
- Muscle spasms
When you get injured, its natural for the site of the injury to become inflamed. Inflammation, which involves swelling of the tissue and blood vessels, is not necessarily a bad thing. Its a natural part of healing and allows immune cells to better access the injured area. Though inflammation can be positive, to an extent, it can also get out of hand and cause debilitating swelling and pain. Ice reduces swelling and inflammation.
Well talk more about the potential adverse effects of ice in the pros and cons section, but its worth mentioning here that ice causes muscles to tighten, which may not always be what you want. If applied for too long, ice can also cause serious issues like frostbite.
Also Check: Atlantic City Personal Injury Lawyers
How Long Should Ice Be Applied For
Ideally, ice should be applied within 5-10 minutes of injury and for 20-30 minutes. This can be repeated every 2-3 hours or so whilst you are awake for the next 24-48 hours.
After the first 48 hours, when bleeding should have stopped, the aim of treatment changes from restricting bleeding and swelling to getting the tissues remobilised with exercise and stretching. Ice helps with pain relief and relaxation of muscle tissue.
About Author: Kirk Wessler
After being a writer for OSF HealthCare for three years, Kirk Wessler retired in January 2022. A Peoria native and graduate of Bradley University, Kirk’s experience included working for newspapers in Missouri, Texas and the Peoria Journal Star.Kirk and his wife, Mary Frances, have five sons, four daughters-in-law and nine grandchildren. Kirk plans to spend his retirement on the golf course, mastering the guitar and traveling.
Losing The Cool: Alternatives To Ice
How, then, does the body clear swelling? Most of the particles are too large to move through the vessels of the circulatory system, so they must instead be evacuated through the vessels of the lymphatic system. The lymphatics, though, are a passive system, fully reliant on muscle activation movement is necessary to propel fluid through the vessels. Sitting still with an ice pack creates the exact opposite effect. With an acute injury, you want to get the good stuff in and the bad stuff out, says Appel, who no longer uses ice to treat the countless ankle and knee injuries suffered by his para-rescue jumpers. The only way to do that is through movement.
Think about it. Do you think our hunter-gatherer ancestors rolled their ankles, dug some ice out of a snowbank, sat down and stopped chasing dinner? It’s more likely that they forged on, and the movement facilitated healing. Pushing a sprained ankle may sound ill-advised, but a 1999 study published in the Journal of the American Academy of Orthopedic Surgeons showed that loading damaged tissue that is, applying force to it accelerates healing of bone and muscle tissue, while inactivity promotes aberrant tissue repair.
Acute injuries, of course, are more complicated. No, you dont want to squat 350 pounds on a torn ACL. But lets say you sprain your ankle. If your physical therapist clears you to stand on it, dont hesitate to do it.
Because the meltdown has already begun.
The Competition: Common Pain Meds
Over-the-counter pain medications are probably the only self-prescribed treatment for pain and fresh injury more common than ice/heat, but their risks and benefits could not be more different. They are quite safe in moderation, but there are serious concerns most people are unaware of, and the best argument in favour of ice may be the relatively unknown problems with these drugs.
All types of these medications are roughly equally effective for acute injury pain, but their benefits may vary for other problems .
Dont take any pain killer chronically risks go up with exposure. Acetaminophen is good for fever and pain, and is one of the safest of all drugs at recommended dosages, but its surprisingly easy to take too much, which can badly hurt livers and it doesnt work well for musculoskeletal pain. The NSAIDs might be a better bet: they reduce inflammation as well as pain and fever, but at any dose they can cause heart attacks and strokesand they are gut burners . Aspirin is usually best for joint and muscle pain, but its the most gut-burning of them all. Voltaren is an ointment NSAID, effective for superficial pain and safer.
Athletes, puh-lease dont take Vitamin I to prevent soreness it doesnt work! Worse, it may impair tendon recovery and fracture healing.
The Art Of Icing: When Youre Numb Youre Done
Slide the ice over the inflamed area in a slow but steady pattern. Its important to keep moving, as long as you dont try to ice such a large area that tissue gets a chance to warm up before you return to the starting point.
Continue ice massaging for 13 minutes, or until it is numb, whichever comes first no more. When youre numb, youre done, is the rule of thumb for safety . Areas with thick tissue, like the top of the thigh, will take longer to get numb. Thin areas, like the side of the knee, will usually go numb quickly.
What does numb feel like? Just close your eyes and lightly touch the skin. If you cant feel it at all, or if you can feel only pressure, thats numb enough. Stop icing and let the tissue warm up.
How Cold How Deep The Effect Of Ice On Tissue Temperature
Thermoregulation of our tissues is extremely efficient: reflex responses in microvasculature can compensate quite a lot for changes in surface temperature. So what happens to the tissue temperature under ice? How cold does it get? At 1 centimetre? At 3? Can you chill a knee through and through?
Turns out you can! Most joints are less insulated and have more metabolically quiet tissues, so they cant adapt to temperature changes as well, and therefore they can be cooled or heated much more easily. In experiments on arthritic knees, Oosterveld et al demonstrated that hot wax could raise deep knee temperatures by 1.73.5C and the effect of cooling was even more dramatic, dropping the temperature as much as 9C. Brrr! Thats likely to have some effect on biology.
The effect on muscle is probably much less, but to date Im unaware of any data that shows it.
To go deeper into this topic, see Icing, Heating & Tissue Temperature.
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When To Go To The Er For Back Pain
The National Institutes of Health estimates that up to one-fourth of American adults experience low back pain each year and that most of us will suffer from back pain at least once in our lives. Mild, occasional episodes can be treated at home with rest and heat. For chronic back pain that’s interfering with your quality of life, make an appointment to see a spine specialist.
When back pain is accompanied by these symptoms, you should head to the ER:
If back, neck, knee or hip pain is slowing you down, learn about your options by taking our free assessment.
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Injured When To Use Ice And When To Use Heat
It may be difficult to know what to do when one first suffers a minor injury such as a pulled muscle or a light sprain. There are so many treatments available, it sometimes confusing as to whether a soothing heat pack is the best treatment, or in some cases whether an ice pack would be the better choice. In the case of a minor injury, there actually is a recognized order of treatment that individuals should follow in order to promote healing so they can get back on their feet as quickly as possible.
R.I.C.E MethodWhen sidelined by an injury, the proper home treatment is rest, ice, compression and elevation of the injured area, also known as the R.I.C.E. method. The first 48 hours after an injury is when an area is most likely to become inflamed and swollen. Applying ice to the injured area during that time helps to reduce blood flow to the injury, thereby reducing inflammation and swelling. The other letters in the acronym, r for resting the injured area, c for lightly bandaging the injury and e for elevating the injury, preferably above the level of the heart, also help to reduce pain.The proper way to ice an injury within the first 24-48 hours is to alternate 10 minutes of ice application, followed by 10 minutes without ice. If you dont have an ice pack, a bag of frozen vegetables is a good substitute. Never put an ice pack directly on bare skin. Always include some type of cloth between the injured area and the ice pack.
Should We Still Be Using The Cold Therapy
Therefore, with all of the evidence on the negatives of topically icing injuries, it may reshape our thoughts and raise a doubt: If ice delays healing, should we still be using it? The answer may not be entirely negative. Although merely applying cold packs or ice on the injured area will reduce inflammation and delay healing, cold therapy does not need to be entirely forbidden since it still has the ability to numb the pain and reduce swelling to some extent. That being the case, we need to know if there is a way to minimize the drawbacks of traditional cold therapy methods and, in the meantime, maintain our ultimate goal to promote tissue healing.
Before addressing that question, we need a basic understanding of the categories of cryotherapy. Generally, cryotherapy consists of two parts based on the way we apply it: local cryotherapy and whole-body cryotherapy. Local cryotherapy is the local application of ice, cold packs, or cold gases, while whole-body cryotherapy primarily includes gaseous application and cryostimulation. Conventional cold therapy always leads to a prolonged application of cold temperatures, which may cause serious side effects such as nerve injuries, healing process restriction, or neuromuscular impairments. Then what about the others?
When Ice Is The Answer
So, is it better to ice or heat an injury? In this section, lets focus on times when its better to use ice.
- Acute injuries: In general, ice is best for acute injuries, which are injuries that affect a specific area on the body. An example of an acute injury is an ankle sprain, which will cause your ankle to become swollen and bruised, but shouldnt directly affect other parts of your body.
- Recent injuries: Another clue that ice is best is if the injury happened relatively recently. Swelling tends to be the most extreme when you first become injured, especially within the first 48 hours.
- Overuse injuries: Athletes sometimes use ice to treat chronic inflammation in specific areas, such as a joint or muscle, from overuse. In these cases, you should only apply ice after and never before activity. If you have chronic conditions, dont treat them with ice outside a doctors supervision.
Sometimes, an injury is unmistakable. You may feel your muscle tear, hear a pop in a joint or feel a sharp pain that indicates youve hurt yourself. When this happens, its usually smart to start icing right away. Well talk about how to do that later in this post. Even if you cant pinpoint the moment of injury, if you just engaged in physical activity and now a specific area on your body is throbbing, you should operate under the assumption that you injured yourself and start icing the painful area.
Why Its Wrong To Ice An Injury
In everyones defense, using ice to effect swelling, inflammation, and pain does make sense on some level particularly if we see them as bad. But a small shift in perspective clearly shows us that we genuinely need swelling, inflammation, and pain for basic healing.
Dr. Ledbetter, a leader in the field of understanding the inflammatory process suggests there can be inflammation without healing, but never healing without inflammation.
In other words, we have to enter the tunnel at the inflamed, swollen stage in order to successfully exit at the healing stage. Otherwise, theres no healing.
Furthermore, attempting to influence these factors with an ice pack suggests we think the body has it wrong and/or we know better.
And when you look at what ice does and compare it to what needs to happen, it may, in fact, slow down tissue healing not speed it up.
Does Ice Help With Pain
Although precise protocols for pain relief are unclear, research suggests that ice can help reduce pain associated with soft tissue injuries. And further evidence supports this idea that theres no value in using ice for acute injuries other than the temporary pain relief and numbing effect.
Ice may reduce pain in two main ways:
Whats the verdict?
- Ice is a safe and effective pain relief modality that is easy to access and apply.
- There are precautions and safety issues to follow highlighted in the following sections.
Is Ice Better Than Heat To Treat An Injury
Your child sprains his ankle during a soccer game. Do you apply heat or ice to the injury? For most people, the logical answer is to apply an ice pack to the injured area. But, do all injuries or pain need cold?
UAMS physical therapist Gayle Quattlebaum says that most of the time, ice is the better choice. When in doubt, ice is better unless there is compromised circulation in that area. Ice is usually the method of choice to decrease inflammation, swelling and pain, which is commonly associated with an acute injury.
Most sports-related injuries are considered acute injuries, which involve all of the following:
- Sudden and severe pain
- Inability to place weight on the limb or move the joint through a full range of motion
- Extreme tenderness and weakness
Even though ice is the better choice, it is important to understand that heat and cold do different things to your body. Keep these differences in mind when deciding to use apply heat or cold to an injury: