I remember a time when “Deep Heat” was the cure-all for a myriad of pains and aches. Lately, there has been a big upsurge of Ice Treatments on the market in the form of Ice packs, freeze gels and sprays. Needless to say like most I was left scratching my head as to what is the best product to use – after all, no one wants to make an injury worse by using hot when you should have used cold and vice-versa, so I decided to do some research.
Ice packs and heat pads are among the most commonly used treatments in orthopaedics. So which one is the right one to use for your injury, ice or heat? And how long should the ice or heat treatments last? Read on for information about treatment of injuries with ice packs and heating pads.
Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury.
Ice packs are often used after injuries such as an ankle sprain have occurred. Applying an ice pack early and often for the first 48 hours will help minimize swelling. Decreasing swelling around an injury will help to control the pain.
With any sprain, strain or bruise, there is some bleeding into the underlying tissues. This may cause swelling, pain and delay healing. Ice treatment may be used in both the immediate treatment of soft tissue injuries and in later rehabilitation.
During immediate treatment, the aim is to limit the body’s response to injury.
- Reduce bleeding into the tissues.
- Prevent or reduce swelling.
- Reduce muscle spasm and pain.
- Reduce pain by numbing the area and by limiting the effects of swelling.
These effects all help to prevent the area from becoming stiff by reducing excess tissue fluid that gathers as a result of injury and inflammation.
Ice treatments may also be used for chronic conditions, such as “overuse” injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity.
How are ice packs used?
- Ideally, rub a small amount of oil over the area where the ice pack is to go (any oil can be used, even cooking oil!). If the skin is broken or there are stitches in place, do not cover in oil but protect the area with a plastic bag. This will stop the wound getting wet.
- Place a cold wet flannel over the oil (you do not need to if using a plastic bag).
- Place the ice pack over the flannel.
- Check the colour of the skin after 5 minutes. If it is bright pink/red remove the pack. If it is not pink, replace the bag for a further 5-10 minutes.
- Ice can be left on for 20 to 30 minutes but there is little benefit to be gained by leaving it on for longer. You run the risk of damaging the skin if ice is left on the skin for more than 20-30 minutes at a time.
- The effect of the ice pack is thought to be improved if it is pressed gently on to the injured area.
Note: ice can burn or cause frostbite if the skin is not protected with oil and/or other protection such as a wet flannel.
Do not use heat on a new injury (for example, soaking in a hot bath, using heat lamps, hot water bottles, deep heat creams, etc.). These will increase bleeding and make the problem worse.
When an injury is older than 48 hours, heat can be applied in the form of heat pads, deep heat cream, hot water bottles or heat lamps. Heat causes the blood vessels to dilate (open wide) which brings more blood into the area. It also has a direct soothing effect and helps to relieve pain and spasm. If heat is applied to the skin it should not be hot, gentle warmth will suffice. If heat is applied there is the risk of burns and scalds. The skin must be checked at regular intervals
Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as “overuse” injuries, before participating in activities.
Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time, or while sleeping.
Precautions when using heat and ice
Do not use cold packs or heat:
- Over areas of skin that are in poor condition.
- Over areas of skin with poor sensation to heat or cold.
- Over areas of the body with known poor circulation.
- If you have diabetes.
- In the presence of infection.
Also, do not use ice packs on the left shoulder if you have a heart condition. Do not use ice packs around the front or side of the neck.