It is interesting to hear different accounts of why heat or ice is a preferred treatment modality or for home self care.We see how emergency rooms typically recommend ice for the first 48 hours after an acute injury while physical therapists always use heat during a treatment session. Most MDs will advise their patients to put heat if after 48 hours or for any chronic condition. Sports trainers use both heat and ice as needed and chiropractors have specific times when ice and heat can be used on the body, sometime in combination. So, who is right?
As a seasoned naturalistic practitioner I happily recommend mild heat when the problem is away from a joint, as in a strained muscle; and ice for any joint pain, because I never prescribe people to take drugs for pain. Ice is an excellent local analgesic and since the pain is caused by a swollen and inflamed joint we certainly don’t want to put heat and increase the swelling to then increase the pain once more.
You see, heat triggers large sized sensory nerves that flood the spinal cord and brain with a volume of stimuli and the net effect is the brain has a louder volume of heat signals than pain signals, so it gives the sensation of relief by distracting the sensory system from the pain. The problem is still there, if not worse if on a joint or left too long on a muscle, but it temporarily it does feel better.
As much as thermal management may have a role in tissue repair, I think this is a good a time as any to advocate the very practical use of massage; and I don’t necessarily imply it has to be performed by a therapist. Anyone can manually massage their body parts. After a 10-15 minute application of mild heat or a 20-30 minute application of ice, it helps a lot to take another five minutes to rub and smooth out muscles and tendons and passively move or traction the joints. Repeated smooth stroking can mobilize waste products and lymphatic fluids away from the affected area.
A couple rules to remember when using cryotherapy or heat therapy.
- Ice 20 minutes for extremities and 30 minutes over the spine areas.
- Heat for only 10-15 minutes (not longer) and keep heat mild to moderate, not hot. Like an egg white becomes hard at 150’F / 65′ C the amino acids in enzymes that repair body tissues deaminate or become denatured. When heat is too hot it can destroy body tissues.
Life is better when we have a simple and clear understanding of how and when ice and heat can be of help. Read more on my earlier article: “Should I Use Heat or Ice?”
Yours in Health,
docMIKE
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