Hot vs Cold - Treating Injuries
Updated: Aug 2, 2018
In collaboration with our friends at West Valley Chiropractic
Heat Therapy VS Cold Therapy
FACT: Injuries happen... have you ever thrown your back out playing touch football? Slammed the car door on your arm? Crushed your tailbone on a trampoline? Dropped a jar of pickles on your foot? ... I could go on.
After, perhaps, some colourful vocabulary you think “Now What?”
Sprains*, strains*, and swelling are often treated with both cold and hot therapy techniques. Knowing the differences allows us to make better use of these therapies in order to significantly increase how effective we are at reducing pain.
Icing injuries has been a common practice for centuries and remains a go to for treating acute* injuries. No secret here - that old bag of peas stays in the freezer for a reason!
How it works:
Cold therapy helps alleviate pain because it works to decrease inflammation* or swelling. Swelling is the body’s natural inflammatory response and acts to initiate injury healing. Redness, heat, swelling and pain, although unpleasant are working to protect the damaged area. Redness and heat are caused by increased blood flow to the injury in an attempt to heal it. Swelling is the result of the increased movement of fluid into an injured area. The release of chemicals and the compression of nerves in the area causes us to feel pain. Applying cold to an injury helps reduce swelling by restricting blood flow to the area.
When it works:
Cool compress therapy or “icing” an injury is recommended for the first 48 to 72 hours after the injury has occurred.
The biggest concern when it comes to using ice to treat swelling is that ice has to potential to cause nerve damage when not used appropriately. When ice is placed directly on the skin, it doesn’t take long before tissue damage may occur due to a decrease in blood flow to the tissue. There is an old First Aid mnemonic "RICE" that is used to treat sprains and strains – it stands for
Some newer First Aid Standards are pushing to change the mnemonic RICE to mean
The reason behind this shift in wording is because of the dangers associated with applying ice directly to injuries. The idea is to cool the injured site in order to reduce swelling, not to freeze or numb the area entirely with ice. To prevent nerve damage from occurring when using ice, wrap the ice in a towel to create a barrier between the ice and the skin. Additionally it is recommended that you ice 10-20 mins on / 60 mins off
Ahh the joys of a warm compresses or a long soak in a tub. Heat can be an effective way to alleviate aching chronic* pains.
How it works:
Heat should be used in more chronic conditions to help relax and loosen the tissues by bringing more blood flow to the area. Heat is often more beneficial when used for extended periods of time. It can be applied with a heating pad to a specific region, or as a whole body treatment such as a warm bath or sauna.
When it works:
Heat therapy is best used for non-inflammatory related pain. Heat is primarily intended for relaxation and comfort to alleviate persistent pain associated with stiffness or cramping. Heat packs are great for complaints of feeling sore or stiff. Warming therapy act to relax muscles. Heat can improve circulation and reduce muscle spasm. However, it's important to note that early application of heat to an injury can increase the level of swelling and thus cause even more pain.
Heat will make some conditions much worse. Never apply heat to an infection or fresh injury/ acute inflammation or to an open wound. Be careful to use moderate heat, for limited time frames to avoid burns. The goal here is “warm” rather than “hot.” Never leave heating pads or towels on for extended periods of time or while sleeping.
If either treatment makes the pain or discomfort worse, stop immediately.
When to seek medical attention:
- You cannot put weight on or move the injured joint without severe pain
- The area looks warped/disfigured or red streaks being spreading out from the injured area
- Your limb buckles or gives way when you try to use the joint
- You experience numbness in any part of the injured area
- You are in doubt about the seriousness of the injury or how to care for it
*Blog Terms for the Nerds at Heart:
Inflammation- Localized reaction that produces redness, warmth, swelling, and pain as a result of injury. Inflammation is your body’s natural response to work to heal damaged areas as blood vessels expand to allow nutrients, white blood cells, antibodies, enzymes and other beneficial elements into the affected area to promote healing.
Sprain - The overstretching or tearing of ligaments. Ligaments are the bands of tissue that connect two bones together in a joint. The most common location for a sprain is the ankle joint.
Strain- The overstretching or tearing of muscles or tendons. Tendons are the dense fibrous cords of tissue that connect bones to muscles. The most common locations for a muscle strain are the hamstring muscle and the lower back.
Acute Injury: Acute refers to an injury occurring suddenly. Common acute injuries are sprains and strains or bone fractures.
Chronic Injury: A chronic injury is a long term or reoccurring injury. Chronic injuries can be the result of injuries that do not heal well and create muscle imbalances, such as weakness or tightness.
Thank you to West Valley Chiropractic for collaborating with us on this topic. Chiropractic adjustments can be used to treat many areas of the body. Depending on the severity of an injury, chiropractic adjustments and massage therapy can be effective ways to treat and prevent pain.
Thanks for taking a moment to check out the blog. As always, we hope you found the content to be informative.
Cochrane Emergency Training Services,
Chelsea & Alex
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The content in the blog is based on up to date research, however it should be considered a matter of opinion . Views expressed should not be taken as medical advice or deter you from seeking medical care for acute and/or chronic injuries.
Standard First Aid Level C Course Manual, Heart and Stroke Foundation