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To Ice or Heat, that is the question…
There’s probably not a day that goes by that I don’t hear the question from a patient “…should I use ice or heat on my back/neck?” As much as I would love to say that there is one answer, it depends upon the condition. But before giving it a try, ask youself this question: “Is it a new injury, and is there obvious swelling?” I can remember being told in my early high school days of playing football, “…when you have an injury, make sure you ice for the first 24 hours, then move to heat after that.” I can’t tell you how wrong that advise was, yet still hear patients telling me the same thing today. The truth is, ice should be used any time there is swelling. To think that the swelling disappears at 24 hours and 1 minute following an injury is ludicrous. Think about it. When you add heat to area, the blood vessells dilate (get bigger) and there is a rush of blood to the affected area. If swelling already exists, you have now added to the problem. Yes, you will feel the warmth of the blood and it may actually feel good, but that doesn’t mean it is good for you. (Kind of like donuts!) So, the best thing to do with swelling is to add ice to the area until the swelling is gone. I instruct patients to use a good ice pack and wrap it in a dry dish towel (one fold to the towel) and apply it to the area for a period of 25-30 mins. And no, 40 isn’t better. Stick within that time frame and if wanting to reapply it, wait at least 1 hour from the time you took it off before applying again. This will provide you with a “site specific” anti-inflammatory in the region where the swelling is present. If no swelling is present and you are wanting to “warm-up” and stretch/loosen a muscle or joint, then typically moist heat is acceptable. But remember, when in doubt, use ice. You will have less adverse effects!
Coming soon… “When do I do ice/heat contrast?”
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