Ice or Heat?

The age old question; “Should I use ice or heat on this?”

As a rule of thumb:

• Ice is for injuries
• Heat is for chronic pain

Generally, you can’t do much harm with ice, so if in doubt, use ice.

Lets break down what effect each of these therapies has on the body:

1. Ice
   • Constricts blood vessels to decrease or prevent blood flow to applied area (vasoconstriction).
2. Heat
   • Widens blood vessels to increase or promote blood flow to applied area (vasodilation).

These 2 examples will demonstrate the proper way to use ice and heat

1. A soccer player rolls his ankle during a game. It is assessed and is presumed to be a mild sprain. His ankle is painful, swollen, red, and tender.
   • ICE
   • Use off and on in 20 minute time intervals until comfortable
2. An office worker has long days sitting and working in front of a computer screen and has tension in the neck and upper back across the shoulders that is consistent day to day.
   • HEAT

KEY NOTE: If the soccer player were to heat his injury, it would promote more swelling, likely making his pain worse.

What does the research say?

• Long term use of ice on an injury will delay the healing process. If ice prevents blood flow, and that blood flow is necessary for the body to deliver healing properties to the injured area, you wouldn’t want to prevent it for long. Localized icing should only be used short term, for pain control purposes.
• Some new research has shown contrasting therapy to speed the healing process. This is performed by using 20 minutes of heat and 20 minutes of ice on the effected area. It works by creating a pump cycle of blood to and from the area, thus leading to faster recovery time.
• Moist heat is deeper penetrating and shown to be more effective than dry heat. Moist heat sources could be hot water packs, bottles, towel wraps, etc. Dry heat sources, for example, are plug in heating pads.

As you can see, ice and heat can promote positive outcomes, utilized in the right way. If you have questions, you should ask your chiropractor.

Yours in health,

Dr. Glenn Ezell