Ice or Heat What to Use and When

Ice or Heat? What to Use and When.

Should you ice it or heat it? When you have an injured, swollen, body part which one should you use? It’s understandable if you’re unclear about this because there ISN’T MUCH AGREEMENT between practitioners who are supposed to know the answer.

Until recently this really was a matter of opinion with health practitioners. Strong, passionate opinion. One doctor says to ice it, the other says to heat it, and another says to alternate ice and heat. Though the MOST POPULAR BY FAR IS ICE.

That seems to make sense. Ice reduces swelling and numbs the tissue so it’s less painful once you get over the initial shock of putting ice on your skin.

Heat is helpful for chronic recurring pain but we are going to focus on ICE because it is the more popular remedy and because… SURPRISE – WE SHOULDN’T BE USING IT!

A quick note to clarify that what I’m telling you only applies to musculoskeletal injuries. Ice may be a lifesaver in other more ominous situations involving organs, dangerously high fevers, etc.
Also, this message isn’t discussing the recent interest in full-body cold water/ice water therapy.  Full-body cold water exposure seems to have real health benefits but that is a different discussion for another time. We’re just talking about ice-packing injuries here.

Back to our regularly scheduled programming… HERE’S WHY WE SHOULDN’T ICE OUR INJURIES.

Inflammation quickly develops in response to an acute injury such as an ankle sprain in order to heal the injury. Acute swelling is not dysfunction.  Acute inflammation supplies the injured tissue with all of the cells and nutrients it needs to heal up.

That seems logical, doesn’t it? Anything that reduces inflammation slows the healing process and might even prevent complete healing.

Now, I’d like to grandstand for a moment about how brilliant traditional Chinese Medicine is and how we’ve been adamant that we should not ice our body parts. WE KNEW IT ALL ALONG! 

Seriously. Traditional Chinese medicine doctors have been saying for thousands of years that icing body parts does not promote healing and it is actually DESTRUCTIVE. 

Why is the medical community slowly doing an about-face on ice? No surprise here. Scientific research.

MULTIPLE STUDIES in the last 10 years have shown that there is NO THERAPEUTIC BENEFIT to applying ice to injuries. A couple of studies showed that ice inhibits the healing process, prevents complete healing, and can even cause nerve damage. Yikes!

A few years ago Dr. Gabe Mirkin, the man who coined the acronym R.I.C.E. (Rest, Ice, Compression, Elevation) as a guide to treating musculoskeletal injuries publicly acknowledged his error in recommending the “I” in R.I.C.E. 

If your primary care doctor or other physicians are still recommending ice for your injuries, don’t worry. They’ll catch up with the scientific results soon. It can take decades for new medical scientific results to become accepted as the norm.
Now, in my opinion, if something hurts so bad that you can’t sleep or just can’t deal with the pain, ice it for a little bit just to reduce the pain. But stop using ice as soon as possible.

Just remember inflammation resulting from an injury is your body healing itself. IT’S A GOOD THING.

Of course, I have to say that if you have an injury that has intensely red skin, and/or severe swelling get yourself to urgent care with haste.

Regarding heat therapy as in applying a hot pack – I have found it clinically very beneficial to hot pack areas with chronic pain conditions such as low back pain, neck pain, osteoarthritic knees and hips, tennis elbow, tendinitis of the wrist, rotator cuff pain, etc. 

Pain that’s lasting weeks and months that doesn’t involve red or severely inflamed skin responds well to heat.

You might also consider asking a physician for help in this case. Wink!

If this is still confusing or you have some feedback please reach out to me.

As always, I’m here and eager to help you and your loved ones feel better.


Sincerely Yours,
Mike Julien

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Ice or Heat What to Use and When
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