Biomechanics Healthcare's Blog

Heat Or To Ice? Understanding Injury Management (Continued)

10th April 2013

I recently talked about the basics of heating or icing an injury. That isn't the end of it however. 
While the 48-72 hr for using ice typically covers most injuries, there are situations to which you can throw that whole idea out the window.

When To Use Ice 

Rheumatoid arthritis is a classic situation. Once it sets in, sufferers will endure the disease for a lifetime. But just because its been there more than 72 hrs doesn't mean you should start to use heat on it. This will only intensify the pain and make it feel worse. The reason is because Rheumatoid Arthritis constantly produces inflammation, and as I’ve already talked about in my previous blog, heat makes inflammation worse. For Rheumatoid Arthritis, ice is the way to go. Another situation is a swollen ankle, which remains swollen for more than 72 hrs. If there's still obvious swelling then you should to continue to ice the injury until the swelling has subsided.

Rheumatoid Arthritis

When To Use Heat

On the other hand, there are situations where you would be suited to apply heat initially instead of ice. An example of something like this is postural related pain - the kind which comes on after you've been sitting down all day in a bad posture. This kind of pain can come on anywhere from the base of the skull, right down to your lower back & pelvis. Usually this is a result of having an incorrect computer setup, using a laptop/notebook or tablet for long periods of simply by having bad posture. While this pain can be quite intense, nagging and sometimes creating headaches, there's not necessarily any inflammation. This is where you will find more relief by immediately applying heat rather than ice.

Very bad posture!

Listen To Your Body

The rule which says icing an injury for 48-72 hrs, then applying heat is really more of a guideline. It's useful in some situations, but not all. What you really need to do is to understand when there is inflammation about and when there isn't. If you're confused, simply listen to your body because your body knows best! Your body will tell you what is working and what isn't in the way of either increasing your pain or giving you pain relief.
Quite often people will tell me that the pain they are in feels much better under a hot shower; that's your body's way of telling you that using heat to treat your injury would be best. If you applied heat to a swollen ankle it will start to throb and intensify the pain. That's a sure sign that you're doing the wrong thing and you should try ice instead.
To summarise, next time you in pain have a think about whether there might possibly be any inflammation or not. If there is use ice, if there isn't use heat and if you're not sure try both and see what works best for you!
Disclaimer: This information is intended as a guide only an not to be taken as proper advice for anyone's specific condition. Always seek professional advice first before attempting to treat your condition.
Rhys Donovan Osteopath Cronulla
By Rhys Donovan


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