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Ouch! Should I Put Heat or Ice on This?

Should I Use Heat or Ice on This?

I am often asked by patients whether it is best to use heat or ice on their complaints. While there is some variation in application depending on the specific nature of a complaint, a good rule-of-thumb is the 72-Hour Rule.

The 72-Hour Rule is as follows:
How long have you had the pain?
1. 72 hours or less = Cold. Pain of less than 72 hours is generally considered acute pain. Acute pain is most often associated with recent injury like bumps, bruises and minor muscle strains. In situations like this, a person is most likely experiencing active inflammation as the body reacts to the recent injury. The application of cold at this time will constrict the blood vessels in the injured area, thus reducing the amount of inflammation and pain the person is feeling.

2. More than 72 hours = heat. Pain of more than 72 hours is generally considered to be chronic in nature. This type of pain is generally associated with older injuries, or it can also be from repetitive stress injuries (i.e. a sore neck/shoulder after too many hours on the computer). Heat will dilate the blood vessels in the affected area, thus better allowing your body to remove inflammation. Heat also tends to relax muscle tissue and can thus soothe overused muscles.

To apply ice: never apply ice directly to the skin. It can freeze the skin and lead to frostbite. I generally recommend patients put ice in a Ziplock baggie with a little bit of water, and then wrap the baggie in a damp cloth before applying to the skin. Ice should be applied until the affected area is numb, but never for more than 20 minutes at a time. After removing the ice and feeling has returned, it can be applied again for another 20 minutes. A 20-on/20-off scenario is generally a good one to follow.

To apply heat: heat comes in many varieties. There are electric heating pads, hot tubs, microwavable packs, capsaicin rubs, etc. Heat can be applied as long as it is comfortable. Obviously, excessive heat will cause a burn, so never put heat on an area that is numb, never apply heat to an infection, and never fall asleep while applying heat.

While ice and heat can be applied at home for minor injuries, always consult a healthcare professional if you are unsure of which modality is right for your complaint.

Joseph Pate, D.C. Doctor of Chiropractic

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