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Ice Pack or Heat Pack... or Both?

April 8, 2016 by Vicki Bushell - Registered Osteopath

We’ve all heard about putting heat or ice on an injury, but which? 

Given that cold & heat are opposites how can both be helpful, surely it’s one or the other?  Here’s our guide on what to use, when to use it and how to use it most effectively.

 

What to use, and when.

In general if something is a recent injury or very acute/painful a Cold Pack can be the most helpful, but when if something is less angry and more of a chronic (long term) ache or pain, alternating Hot and Cold packs can be much more beneficial than Cold Packs alone.  


Cold Packs.

Why?

To decrease inflammation in area caused by injury - often this inflammation is the main source of pain - and ‘numb’ the nerve endings reducing feelings of pain.  The cold also takes the blood away from an area by the contracting blood vessels, which then relax (when the cold pack is removed) and blood flushes back bringing in fresh nutrition to promote healing.

How?

Use a frozen wet towel/ flannel, bag of frozen veg, or best of all is frozen Gel Pack.  Whatever you use it must be wrapped in a cloth to protect the skin and prevent frost bite.

Place on the affected area for 5-15 minutes (max. 20 mins)

Remove for at least twenty minutes and repeat up to three times if necessary

Repeat at regular intervals throughout the day depending on the severity of the injury

 

Alternate Hot and Cold Packs. 

Why?

Alternating hot & cold improves circulation by relaxing and then contracting blood vessels – similar to the Ice Pack but more pronounced.  However, heat also relaxes the tissues (as well as the blood vessels) then the cold stops the injury area becoming too heated which would prolong the inflammation.  Ultimately the aim is to decrease inflammation in an area when the main source of (chronic) pain can be caused by ‘congestion’ or tightness of tissues, often made worse by muscle spasm.  This congestion can interfere with blood flow and therefore healing.

How?

Use a hot water bottle or ‘wheatie bag’ (follow the instructions carefully to prevent burning), again it can be wrapped in a cloth to protect the skin and placed on the affected area for 5-10 minutes. 

Follow this immediately with a Cold Pack (see above) for approximately 5 minutes.

Repeat - up to three times is ideal, and always finish with the Cold Pack

NOTE; when using alternating hot & cold packs the temperatures do not need to be extreme; warm and tepid can be equally as effective for some people.  Also, the hot element can also be having a warm shower or bath – followed by a Cold Pack.

 

Heat Packs. 

Some people might suggest using only heat packs.  Personally I do not believe that has any therapeutic benefits beyond making the muscles feel more relaxed.  It can actually bring more blood into an already swollen tissue, and when it is removed the tissue can remain congested.  Cold drives the body more to react, and although it isn’t as pleasant, it has a stronger reaction after it’s removed.

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