Monday, July 23, 2012

Ice versus Heat -- Part 2


Ice, however, decreases the swelling in damaged tissues, allowing the blood to flow in a less restricted manner.  Additionally, because the area becomes cold enough to concern the body, it will actually shunt more blood through the injured area in an attempt to warm it up again, thus providing an excess of the oxygen and nutrients which, in turn, allows the body to perform the highest quality healing possible.  Also, ice provides other benefits which include pain reduction due to the numbing effect, and muscle relaxation as the area warms after the ice is removed.

The area in which I part company with current schools of thought on cryotherapy is in the length of time for which it is beneficial.  I have read that application of cold is only necessary for anywhere from three days to two weeks following injury, depending on the source.  My personal experience indicates that this is incorrect.  I believe that ice continues to have value for as long as the pain and discomfort persists – my patients report continued observable improvement long beyond the two-week limit.  I can only explain this with the possibility that the body interprets the pain as continuing injury and responds by maintaining the swelling, internally, even if no longer visible externally.

For ice only:  15-20 minutes on and 45 minutes off before repeating.  As you may have already deduced, whether ice or heat, the benefit comes after it is removed and the body attempts to restore itself to correct temperature.  At least 15 minutes is necessary to trigger the full effect, but anything beyond 20 minutes is a waste of time.  I do have some patients who choose to leave the ice on until it melts, or even fall asleep with it on, because of the lack of pain while it is numb (I don’t see a problem with this as long as you don’t get frostbite).

BTW Icy Hot®, Biofreeze®, etc. are better than nothing when you can’t use ice, but they don’t replace ice.

Getting rid of your pain,
Dr. Steven Ray, Chiropractor
Val Vista Chiropractic

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