We use a couple of types of cryotherapy including cold packs and Biofreeze®, a topical pain reliever. Both of these modalities help to decrease pain, inflammation, and enhance the effects of the treatment. They are also key components of our home exercise programs. For years, you may have heard that you should be using ice for the first couple of days and then switch to heat after that, but read below for a recent blog as to what you should really do!
Check out This Blog Post By Dr. Beth Meliski:
Do you use Ice? What about heat?
Often times I hear these questions posed by new patients. Most are surprised to learn that we use ice instead of heat in our rehabilitative setting. Truthfully, I understand their perspective. To me, nothing feels better than a cozy blanket and a nice cup of coffee on a crisp autumn day. However, my understanding of the human body and current research methods may contradict feeling good at the moment with feeling better in the future. When it comes to understanding heat versus cold, we must first understand the goal of the treatment. At Sport and Spine Rehab, our goal is to reduce pain, restore function and improve quality of life to help each patient live a healthier, happier life.
When patients come in reporting pain…
We can usually surmise inflammation is occurring at the site of the effected area. Inflammation is a broadly used term in the healthcare community and by definition it really entails the immune system’s protective response to a stimulus. I typically compare inflammation to a fireplace in a home. Much like the fireplace, when the signals of inflammation occur our temperature increases too. Not only will the temperature rise, but swelling, redness, loss of function and pain can also occur. So when you add a heating pad to an inflamed area, just picture adding a tub of gasoline to a controlled fireplace. Not good! With massive amount of fuel added to the fireplace, other parts of the house may become ablaze. Much like a localized inflamed tissue, the effects of inflammation can spread to surrounding areas.
So why do we use cold packs?
To put the fire out! The application of cold may help to reduce swelling and reduce the blood flow that brings the immune cells to the area causing pain and inflammation in the first place.
Does that mean all heat is bad?
Not necessarily, heat has it’s place. Much like a fireplace protecting the house from the outside cold, inflammation and heat can serve it’s purpose. Inflammation let’s us know when things aren’t right by activating the immune system. The signals of pain are telling to, “PLEASE HELP!” So don’t ignore them. Your body is communicating with you, just listen.
When patients are past the acute phase of pain, some heat may be beneficial but this is on a case by case basis. In addition to applying heat, I recommend patients move or stretch afterwards. Just like you would jog to warm up for a sport or lift light weights before stacking the heavy ones, you are warming up muscles. Adding heat to a muscle warms it up so it’s best to move around afterwards, instead of sitting or laying down. All the swelling and added blood flow to the area with no movement may result in more pain and stiffness later.
Ok, so when do I know to use ice or heat??
As always, consult with your trusted healthcare provider. At Sport and Spine Rehab we always use cold because it helps reduce muscles spasms, decreases inflammation and has revealed more promising results with muscle re-education when compared to heat. So the next time your in pain and need relief, think of the cozy fireplace. Sure the warmth may feel nice, but putting the fire out is necessary. Much like the house, our body is a structure too and a constant fire with constant fuel is a recipe for disaster.