With nearly any injury, like a sprained ankle or if you bend over and feel your back pop, use ice to reduce inflammation. The way to remember this is to think about the Super Bowl. Along the side lines, do you see huge ice containers or large heating pads. Well, of course, we all know it is ice buckets. If it is good enough for the NFL players, then it is what you should use.
The rule of thumb recommendation is twenty minutes on and twenty minutes off until the pain or swelling subsides. As an alternative, you may want to use this method to determine how long to keep the ice on. The ice application will initially feel cold, then hot or you will experience a burning type sensation, after that you feel an achiness and finally numbness. Once you get to numbness, you can remove the ice pack because you have acheived your treatment goal. You then let the skin warm up to room temperature and you can repeat the process.
For small areas or very swollen areas, an ice massage is recommended. Ice massage is using an ice cube to massage the area. Remember to apply warm water to the area so the ice cube can glide. Also use a paper towel to hold the ice cube. You should go through the same stages to get to numbness.
Ice is the preferred treatment for almost every situation a layperson runs into and should be your "go to" choice.
Yes, heat feels better. But it is not nearly as effective and will often cause a delay in healing time if applied improperly. Heat should NEVER be applied to a brand new injury. Heat is only for specific problems. Even then has to be applied and monitored carefully. I always tell patients that if you are not a turkey do not cook yourself. Application of heat for long periods of time will "cook" the tissue and cause damage that may double or triple healing times.
Heat brings blood and fluid to the injured area. You would use heat on old problems that are aching, like an old footbal knee, or you could use it to relax large muscles. Heat should not be used by the layperson without professional advice if there is numbness, tingling or "nerve pain".
A good rule of thumb is to use moist heat for no more than 10 minutes on an area. Warm moist towels, hot tub, bath or a hot water bottle will all do the trick. If the area turns pinkish-red then you are doing it right. If it turns bright red, that is too hot or applied for too long.
Finally, alternating ice and heat applications is a great solution for that painful area which has started to heal. Most authorities state that you can start alternating ice and heat after 48-72 hours. I usually recommend starting with an ice/heat/ice regimen if you are starting alternating therapies that early.
Another great solution for temporary pain relief is a topical analgesic like BioFreeze or those analgesic pads sold by various companies such as Icy Hot.
If these simple home care solutions do not help in just a few applications, it's best to call the office and get the situation checked out.
Hope this answered your questions. Til the next time, Dr. Hovi
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