Ice, Ice, Baby
One common question patients ask me pertains to the use of heat or ice. Each has different effects, and their use can depend on which type of effect you are looking to achieve.
Heat is an analgesic, meaning that it will block the perception of pain. A few years ago, products providing low level heating that can be worn for several hours during the day became popular. These products can be used while being active. They have been shown, in clinical studies, to provide some good benefit.
Ice is an anesthetic and an anti-inflammatory. While heat blocks the perception of pain, ice blocks all sensations.
Due to its anti-inflammatory properties, the use of ice is recommended for the first few days following injury. (There is concern that heat can cause an increase in inflammation. Therefore, its use during the first few days after injury is not recommended.) A simple rule of thumb is this…if it is bruised or swollen, do not use heat. Use ice instead.
I recommend the use of an “ice massage”. Simply fill a disposable insulated cup with water and freeze it. (Some thin cups will tear as the water expands when it turns to ice…in that event, put ice cubes in the cup and top it off with water.) Tear the top of the cup off, exposing the ice. Apply it directly to the involved area. Move the ice over the area. Do not keep it stationary.
The first thing you will notice is…it is cold. Yes, ice is cold. Very cold. It is…ice cold. My advice to you is to bear it for the first few minutes, because after a while it will not feel cold. Instead, it will burn. (I know that doesn’t sound like much of a trade-off.) My advice is again to bear it, because after a few more minutes the area will get numb. This is the effect you are looking to create. It typically takes eight to ten minutes to achieve this. Your skin should show a bright pink hue. It should be extremely cold to the touch. (Don’t give yourself frostbite!)
Regularly icing an inflamed body part will reduce the inflammation and thereby reduce the pain, beyond just the temporary numbing effect that ice offers. This can be effective for both acute inflammation, as in an ankle that has ballooned up due to a sprain, or chronic inflammation as can occur with tennis elbow.