Should I use ice or heat on my injury?

One of the most common questions that I get is when to use cold or heat therapy on an injury.  It is very important make the correct choice to shorten healing time and most of all, not make the problem worse. Cold therapy, usually in the form of an ice pack, should be applied as soon as possible to an injury.  The cold will help to constrict the flow of blood to the damaged area reducing swelling.  Swelling causes pain and the more swelling that occurs, the longer it will take to clear it.  Most texts say use cold for 24 to 48 hours following an injury, then go to heat. This may not always be the case. Heat therapy is used to increase the flow of blood to an area to aid in the repair to the damaged tissue.  If heat is introduced too soon, it will increase swelling and lengthen the healing time. I have seen hundreds of patients over the years make themselves worse by using heat and none by using cold.  So, my number one rule is:

When in doubt, use cold.  

One has to keep in mind that as we are going through the process of getting ourselves back to normal we frequently cause re-injuries.  When that happens, you must start all over again with cold. How do you determine when to make the switch from cold to hot?

If movement and activity seem to cause more pain, use cold and if movement and activity seem to make things better, use heat.

It may be a little hard to tell if movement of the injured part changes the pain.  If so, go back to rule number one. One other scenario is that you may wake up in the morning feeling sore and stiff.  As you move about it begins to feel better. As the day wears on it begins to feel worse.  In this case you would use heat in the morning and ice later in the day. If you have any questions, give us a call today.