Heat or Ice for strains & pain?

How often do you pick up a new strain or nagging pain? It's almost impossible to live without picking up niggly injuries that aren't so serious that you immediately think to seek medical help or so mild that you ignore them. Soothing the site of pain is the logical thing to do and, unlike many things in life, something you have complete control over. Also, the longer you live on this spinning rock we call home, the more susceptible you are to these everyday strains that can get in the way.

When these arise, though, what is the best course of action? The two front runners tend to be heat or ice, but what to use and when is less clear. Much less. Do you use both? Not simultaneously, unless you are this ageing Baseball pro - Link to YouTube video. It's a question I get asked an awful lot in the clinic, so I decided to impart my time-served wisdom on you and hopefully help ease the pain and associated headache from proceedings by trying to answer. Which, When & For What?

First off, I usually recommend that you do not use heat on acute injuries - acute injuries are essentially injuries less than six weeks old - as the additional heat can help to increase inflammation and, as such, will prolong the time the injury takes to heal. Avoid using heat as it is more comfortable than an ice-cold solution; you can worsen an injury by applying heat where it's not needed. For patients who keep introducing heat to an injury that is less than six weeks old, this can delay the healing process as the body is unable to heal if it is still in an inflammatory state; adding heat can prolong the inflammatory stage. Ice is your best friend with fresh injuries of this type; it will help to reduce the swelling and will aid in numbing the pain while simultaneously reducing tissue damage.

For injuries older than six weeks, the preferred option would be to use heat. The heat increases blood flow to the site of the pain and will work to relax muscles and joints. The heat helps you safely start working towards an increased range of motion, which will help your recovery should your injury be around a joint. Apply heat before pushing your range of motion too far by stretching or doing a home workout. Don't be afraid to use heat and ice during the same 'session'. You can still use ice therapy after exercise to help stop any bouts of inflammation. Warm-up and cool down after. 

Arthritis: If you have Arthritis, heat will be your friend here, preferably a fully immersive moist heat best found in your bathtub. Warm but not too hot will give you the best relief, not only for your joints but your skin, too!

Bouts of Gout: The one arthritic condition for which ice works more effectively is gout. When pain and inflammation flare up in your joints, ice can quickly numb the pain and reduce the swelling to give you greater comfort.

Tendinitis: Ice again will be your best option here, but you may want to finish with some heat, especially around your Achilles tendon and your elbow, if pain flares up in these areas.

With all of the above concerns, you can apply your ice and heat treatments in various ways and via many mediums, but most experts agree on timing. If you stick to the 5-10 minutes on, 5-10 minutes off rule, you'll see more significant benefits with less discomfort. If you have a specific pain that I haven't covered above, please don't hesitate to contact me for further advice; I'm always happy to help. That helps clear up the age-old debate and keep you safe. I'm still open to anyone who needs some hands-on help. I hope to see you soon.

Until next time,

Sophie x

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