As much as it might hurt, swollen and inflamed tissue contains the components of healing that your body uses to repair itself after an injury. A good example is an ankle sprain. Depending on the nature and severity of the injury, in orthopedics, we treat inflammation using anti-inflammatory medication, elevation of injury, massage, cortisone injections, compression and rest. Ice cryotherapy beats heat thermotherapy for treating pain and inflammation in most circumstances. Although heat initially feels warm and cozy, ice helps decrease pain and inflammation in the long run.
Ice constricts, or narrows, blood vessels. Constricting blood vessels inhibits the body from allowing inflammation in the iced area. Heat dilates, or widens blood vessels, allowing more inflammation to flow to an injured or painful area.
As a general rule of thumb, ice should be used if you have recently injured an area or had surgery or a procedure. Medical studies agree that 20 minutes of icing is most effective. You should ice with a cold compress or ice pack that is the temperature of a melting ice cube. Some people have cold allergies, which cause ice to burn the skin. Put at least a thin towel between the ice and skin to avoid burned skin.
Greater than 20 minutes of icing can cause reactive vasodilation, or widening, of the vessels as the body tries to make sure the tissues get the blood supply they need. Studies have also shown 30 to 40 minutes in between icing sessions are needed to counter this reaction.
The suggested time for icing is 20 minutes on and at least 30 minutes off. Although many articles and studies may say that heat should be used for injuries and pain that have lingered for longer than six weeks, this is not necessarily the case. For conditions such as chronic tendonitis and osteoarthritis, the body thinks that it can heal the worn or injured area. The body continues to go through a cycle of increased inflammation even though it cannot heal these conditions on its own.
Icing for 20 minutes several times a day can work as well as, if not better than, oral medications and injections. By controlling inflammation, symptoms often resolve or improve and pain subsides. Heat does have its role.
Heat works best in larger muscle groups. Heating the injury immediately after it happens may cause further damage. Heating a sore or injured muscle increases blood flow and metabolic activity which leads to a loosening of muscle tissue.
Warming an injured area relaxes stiffness and relieves pain in aching joints, such as those affected by arthritis. Regularly heating before a practice or game can also help with avoiding stiffness as warm-ups transition into performance. This will also loosen up the muscles to avoid injury or soreness. For example, heating a shoulder prior to and while pitching in a baseball game may help contribute to a longer time spent on the mound.
Heating pads are the most common form of heat treatment, but there are a few methods you can use depending on what kind of heat you need. Directions: Fill the plastic freezer bag with 1 cup of rubbing alcohol or 1 cup dish soap. Add 2 cups of water. Remove as much air as possible out of the freezer bag before sealing it shut. Is it necessary? One thing is for sure: it can help decrease your pain and make you feel good.
When icing, use the CBAN method, keep the ice on for only about 10 minutes, and keep your body part moving before and after icing. Checking with your healthcare provider or physical therapist is a good idea to learn exactly how to manage your injury.
When ice is used to reduce pain and inflammation caused by an injury, including after surgical procedures, it's called cryotherapy. Probably not. It's generally advisable to expose skin to ice for no more than 10 minutes at a time, with a 30 to minute break between applications.
It can put you at risk for a number of complications, including frostbite and tissue necrosis. There also have been isolated instances of compartment syndrome a painful muscular condition and perniosis inflammation of small blood vessels in reaction to cold exposure associated with over-icing. In general, it's OK to use ice for as long as you have pain, swelling, and inflammation. A typical protocol is to apply ice for 10 minutes at a time once per hour for the first 72 hours.
From then on, ice should be used three times a day—morning, midday, and a half-hour before bed—for 15 to 20 minutes. Get exercise tips to make your workouts less work and more fun. Cold-induced vasoconstriction may persist long after cooling ends: an evaluation of multiple cryotherapy units. Knee Surg Sports Traumatol Arthrosc. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?
J Athl Train. The cold, hard facts of cryotherapy in orthopedics. National Organization for Rare Disorders. University of Michigan Health. Using Ice and Cold Packs.
Nov 16, Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. These choices will be signaled globally to our partners and will not affect browsing data. The physician who coined the acronym "R. E" in the late s has changed his stance on using ice on a sports injury.
Gabe Mirkin, author of one of the most popular books about sports medicine, wrote a blog post updating his position on the recommendation to use "rest, ice, compression and elevation" for the immediate treatment of sports injuries, such as strains and sprains.
Citing current evidence, Dr. Mirkin writes that it now "appears that both ice and complete rest may delay healing, instead of helping.
The evidence has found that icing a soft tissue injury will reduce swelling and inflammation, which had been thought to delay healing. Now researchers believe that inflammation is actually a necessary component of proper healing.
Mirkin explains that inflammation is similar to the way the immune system attacks other foreign invaders such as germs. When there is damage to the soft tissues—such as muscle pulls, strains or general soreness—the immune system responds by sending inflammatory cells called macrophages to the damaged tissues. Once there, these cells release IGF-1 insulin-like growth factor , and this hormone helps the damaged tissues rebuild, repair, and heal. Research indicates that applying ice to the injured area prevents the release of IGF-1 and ultimately, delays healing.
We've known for some time that ice works to reduce pain and swelling. We also know that cold causes blood vessels to constrict. The unwanted side effect of this constriction, however, is that inflammatory cells and their healing hormones are prevented from getting to the injured tissues. Mirkin points out that once these blood vessels are restricted, they stay closed for hours.
The lack of circulation can result in tissue death and may actually cause permanent nerve damage. Mirkin also argues that anything athletes do to reduce inflammation delays healing. That includes taking inflammatory or cortisone-types of medicines, using ice or other cold packs, and anything else that stops or blocks the immune system's natural response to an injury. The main benefit of icing an injury is to help control or reduce pain.
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