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 JANUARY 31, 2012 When Ice is Better than Heat to Treat Pain Is ice better than heat to treat the pain of a sports injury? The answer is it depends. The reason it depends is that heat and cold do different things to your body, says Julie Silver, MD, Assistant Professor, Harvard Medical School, Physical Medicine and Rehabilitation. Cold works by decreasing the temperature of the tissues. This causes the area to become numb. Dr. Silver explains that cold acts as a local anesthetic, which can be very helpful in relieving pain. Also, cold causes blood vessels to narrow, called vasoconstriction, and lessens swelling and inflammation. For a new injury in the first 24-48 hours Dr. Silver says the goal is to limit swelling and inflammation. Icing is used in the common sports medicine mnemonic RICE, which stands for Rest, Ice, Compression, and Elevation. If you have any cuts, lacerations, open wounds or any risk of internal bleeding, then heat isn’t a good idea as it promotes more bleeding. But don’t keep ice on for longer than 20 minutes or so because this can cause tissue damage or “burns.” Also, it’s important to avoid using ice on fingers and toes if you have circulation problems. The ice causes even less blood to flow and may permanently injure these parts of the body. When to Use Heat Heat causes the temperature in your tissues to increase, which relaxes your muscles and also allows the blood vessels to expand. This, she explains, is called vasodilation. Heat delivers more oxygen and nutrients to an injured area. Since heat increases blood and lymph flow, warmer tissues may have more swelling and become inflamed. After the first day or two, the muscles around the injury may get very tight. Then, heat can really be helpful. For chronic injuries, heat is often the best modality to use to relax the muscles and improve flexibility. However, in chronic joint pain, such as arthritis, then cold may be better because it numbs the area and reduces inflammation. If you aren’t sure whether to use hot or cold packs, talk to your doctor. If you have a chronic injury, consider which one of these has helped you the most in the past – that’s probably the one to use regularly for the best relief, says Dr. Silver. |
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