This is a common one that comes up in our office all the time. There are a couple questions that you have to ask, but as a general rule ice is better than heat. Ice reduces inflammation which is generally responsible for the sharp pain you may be experiencing. Many times we use ice to aid the healing process. There is no healing without inflammation! The problem is that inflammation is not very efficient on its own, it tends to all rush in and try to fix the problem all at once, creating a gridlock-like situation in your blood vessels. Ice closes down the blood vessels, squeezing the inflammatory cells and blood products out of the area. This allows new, fresh blood products and cells to come in and heal the injured area. In this type of icing, the number of cycles that you have the ice on and off is critical to how well the ice works. The more cycles you can ice, the better, and faster, the area will heal. Think of it as wringing the soap out of a sponge. The soap never really gets rinsed away if you simply run water over the sponge, but if you squeeze the sponge you can clear the soap very quickly.
Heat is appropriate in some situations. It is generally easy to tell when to heat by the type of pain you are having. Sharp or stabbing pain should always be iced, dull or achy pain that does not have any kind of sharp component (like with certain movements) can be heated. This type of pain is very common after a good workout, but wait about 24 hours after the workout to make sure there is no sharp pain which would indicate an injury. It is also appropriate to heat an area after an injury as long as ALL of the sharp pain has passed. Heat will allow the blood vessels to expand, which will clear any lactic acid built up in well worked muscles. It will also make the muscles, tendons, and ligaments more flexible which will relieve a lot of stiffness. Stretching after heating is a great way to increase flexibility without risking additional injury to the soft tissues. A hot tub is one of the best ways to heat an area, but if one is not available a long, hot bath will do just fine. Even a long shower can be a very beneficial method of heating an area. A dry heating pad placed over an area is the least effective method of heating. Without the moisture the heat never really penetrates the skin to get to the muscles below. Some heating pads come with a wettable cover to supply moist heat, but I am not a big fan of mixing water and electricity.
I hope this has been educational for you. As a reward for reading this post tell us the secret password: CHATTANOOGA for $5 off of one of our high quality ice packs that we have for sale in the office.
Contributed by: Dr. Moulder
