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Ask the Vancouver Chiropractor: To Ice or to Heat?

By Edited May 4, 2014 0 2

Ask the Vancouver Chiropractor: To Ice or to Heat?

This is a commonly asked question in health care offices that is commonly incorrectly answered and as such, causes patients to endure greater pain and longer healing times than necessary. Pain after an injury or overuse of an area of your body is partly a result of inflammation or swelling of the affected tissue whether it is bone, muscle, ligament or tendon.

This inflammation causes pressure on the adjacent sensory nerves which convey information to the brain hence causing the feeling or sensation of pain. Inflammation also reflexively causes the soft tissues of the affected area to "tighten up" or become contracted adding to the pressure on these sensory nerves. That is the one of the reasons muscles tend to tighten up and remain tight for an extended period of time after the initial injury or overuse activity.

After an injury it is recommended to ice 8-10 minutes per application up to 4-6 times per day until the acute inflammation has subsided and there is no pain with movement of that area. This plan stays in effect as long a there is pain. This is the key.

Chronic pain and tension develop if the inflammation in an area is not dealt with properly. Reducing the inflammation combined with the proper in-office treatment and prescribed home care and activity regimen provides the best short and long term results. The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced.

I suggest wrapping the ice pack with a moist face cloth before applying it to the affected area. Good results are also achieved from a bag of frozen peas or an ice massage with water frozen in a paper cup (peel the cup down as the ice melts). Be careful not to leave ice on your skin for more than the suggested time as there is potential to burn your skin.

Heat application on the other hand is used in those instances with chronic discomfort usually due to tight tissues where there is no inflammation or swelling. It is ideal for stiff or nagging muscles. Athletes with chronic muscle stiffness commonly use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow.

Be careful, heat application increases the blood flow to the affected area and tends to increase existing inflammation. Heat application is one of the most common errors in treating inflammation and results in prolonged disability and pain. Applying heat to a body part that is still inflamed will increase the longevity of symptoms arising from the injury specifically pain and stiffness. It is therefore not recommended for acute injuries or injuries that show any signs of pain and inflammation.

When indicated, safely apply heat to an injury 15 to 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Moist heat is best, so you could try using a heated moist towel.


Jun 4, 2010 9:53am
I find the heated moist towel works the best. Great article!
Jul 20, 2010 1:31pm
Thanks for the feedback Sookie. I do as well.
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