Ask Dr. Chris

Ice versus Heat  which is better?

Dr Chris A. Hawn

Whenwe’re done, you’ll have a great understanding of which one to use and which oneto stay away from.

Whenwe talk about these two treatments, we have to discuss what we are actually tryingto treat. Is it Inflammation? Whether itis from a bruised body part or sprained ankle, if it is musculo-skeletal tissuewe are talking about, it’s all basically the same. The only difference is theamount of time on each area.

Formany years, most medical professionals have liked to recommend heat formusculoskeletal injuries.  After 30 yearsin practice, I can tell you that they are ABSOLUTELY WRONG. In most cases, thebest early application is an ice application.

Let’simagine you slammed your thumb with a hammer. Aside from the fact that you arein pain, you know that the thumb is going to swell. This is your body’s way ofprotecting the damaged tissues. It sends fluids to the area to puff it up toprotect it. Much like you put bubble wrap or peanuts in a fragile package tosurround and protect it while being shipped.

Nowlet’s imagine that you wanted to go into the spa or Jacuzzi that night withyour significant other. You make your way slowly into the water and eventuallywork your thumb underwater. In the beginning, the thumb might feel a bit betterbecause all the blood vessels are dilating and bringing blood to the area. Forawhile, you will be able to gently move it.

But Wait! 

Whenyou come out of the Jacuzzi, it is only a matter of minutes before your thumbbegins to throb and swell up and hurt a lot more than it did BEFORE you put itin the hot water. That’s because puttingheat on that thumb was like putting gas on a fire. It was contra-indicated.

Remember,the body is smart and it creates swelling to protect damaged cells and tissue.

Then what should Ido? 

Whatyou want to do is use ice to reduce the swelling and inflammation. But how longto I use it for?  I heard that many practitionerstell their patients the same amount of time for everything.  30 minutes on and 30 minutes off, an hour onand an hour off. This is insane!

Thethickness of the body part dictates the amount of time. A wrist for example hasa thinner layer of tissue between the skin and the bone as compared to the lowback where there are multiple layers of muscle. Obviously, the low back wouldrequire more time than a wrist to be able to penetrate the tissue.

Ifyou leave ice on too long it will work against you. Have you ever had yourfingertips freeze up in the snow?  Thatfreezer burn feels exactly like the name, a burn. Your body may be heating you up inside tocounteract the fact that you are freezing the cells which are primarilycomposed of fluids. Therefore, it feels like a burn.  This is the result of cold application being onit for too long.

Ask your doctor what the ice applicationrecipe is for your particular condition because I can surely tell you that onesize certainly does not fit everyone.