Heat or Ice?
Many individuals in physical therapy find themselves perplexed when they are forced to choose between heat or ice for their injury. Unfortunately, it is not as simple as some articles and professionals state. Some argue that all issues should begin with ice and then graduate to heat later. Others claim that you should not use ice at all. Physical therapists also run into patients that have preferences that seem to work better for them for whatever reason. With all of these nuances to consider, some guidelines can help guide a patient or athlete to make the most informed decision not to aggravate their injury. Overall, it is a balance between ice and heat, and each has certain properties that can be beneficial to different people. The right thing to do is to have professional assessment and guidance to determine the proper treatment.
What Can They Do?
In whatever circumstance a patient in physical therapy decides to use these analgesics (pain-relievers), it is usually in the presence of an injury. Pain can result from or trigger inflammation, whether post-surgery, during rehabilitation, or after strength and endurance training. Ice and heat can have opposite effects on this, which impacts the level of pain. Ice and heat, when used correctly, can help decrease swelling, limit pain, encourage movement, and promote relaxation. Whatever the goal, the physical therapist and patient should be mindful of several factors before administering these pain-relievers.
Ice constricts blood vessels and the size of the swelling. A sudden injury may create symptoms in the affected area, including redness, pain, hotness, and swelling. Ice provides an easy, cheap, and effective way of dulling these symptoms. The injuries one often uses ice for include shin splints, runner’s knee, tennis elbow, and Plantar Fasciitis. The irritation in these injuries is often relatively superficial, which allows ice to penetrate deep enough to treat the pain.
When Ice is Not the Answer
In some cases of neck and back pain, skilled therapists do not encourage using ice, which can leave the patient feeling more acute pain than previously and with stiffer muscles. In a similar case with a stiff muscle from whiplash or intense workout routines, the ice may only exacerbate the inability to move. Even with these guidelines, it is important to treat each injury individually, not by a concrete set of rules.
When You Should Use Ice
Ice is great for treating acute or fresh injuries that cause inflammation. This drug-free, mild treatment lessens pain and bolsters range of motion as the swelling decreases. In most cases, you will hear that ice is better for fresh injuries, like those resulting from a sprain, strain, or impact.
Heat in the form of heat packs or hot showers is another cheap and easy way of relieving pain. Higher temperatures are naturally relaxing for the body and help soothe and encourage muscles and nerves to calm. Heat’s ability to increase circulation is part of why it can help with the healing process. As blood, oxygen, and specialized cells enter the injured area, they aid with recovery.
When Heat is Not the Answer
Never apply heat to a fresh injury, over an incision after surgery, or to an infection. The increase in circulation can cause an injured site to inflame even more and create even more pain. Always consult a doctor or physical therapist before starting a heating regimen post-surgery.
When You Should Use Heat
Spasms, stress, cramps, fatigue, and most non-inflammatory injuries can benefit from heat. The relaxation and reassurance that heat provides for these situations cause more than a psychological reaction but a physiological one. The less tense the individual is, the easier it will be for them to heal. Athletes find heat beneficial after an intense workout or long periods of travel.
To learn more about the decision between ice and heat, check out this article on ice vs. heat for pain and injury. If you are unsure if your chronic or acute injury needs ice or heat, please consult one of Mid-County Physical Therapy’s physical therapists today.