Ice or Heat?

What do I do?  Use P.R.I.C.E!

Often patients ask if they should use ice or heat on a new injury.  Most people think heat feels better, and sometimes their family doctor or the ER told them to use heat. JUST SAY NO to heat, heating pads, and heating gels!  For injuries, even a strained back, using heat may feel better while you use it, but it will cause more swelling and prolong the injury!

P.R.I.C.E. is an acronym for the most important elements in first aid of many injuries.  You can use this word to jog your memory when you have injuries like bruises, joint sprains, muscle strains, back pain and other new injuries. 

PROTECT – Protect the injured area using splints, ace bandages, slings or simply wrapping a pillow around the injured area during transport. Keep the injured area from being bumped, moved or further damaged.

REST – Stop using the injured part and rest it. Adhering to the old theory of “no pain-no gain” can cause further injury and delay healing. Be aware that resting for too long could also delay recovery or cause other problems. Your doctor can give you more information on how and when to rest your injury.

ICE – Ice helps stop the inflammation and bleeding. It reduces swelling and any secondary damage which significantly speeds recovery time. It is important to note that there is a proper way to apply ice.

• Ice the injured area for 15-20 minutes using a bag of ice cubes, a re-freezable ice pack or a package of frozen vegetables. Place a towel between your skin and the ice pack.
• Remove the ice to allow the skin to warm up to normal temperature for 1 hour. (Do NOT use heat.)
• Continue this cycle until the swelling has decreased. If pain and swelling persists for more than 3 hours, consult your doctor.
• Ice can be used at any time for pain control or if the swelling returns. 

COMPRESSION – Compression decreases swelling by slowing bleeding and limiting the accumulation of fluid near the injured site which can delay healing. You want to use an Ace bandage if possible but any kind of cloth will do for a short time if need be. Wrap the injured area by slightly stretching the elastic bandage. Begin below the injury site and finish above the injury site. Be careful not to wrap too tightly or blood flow will be severely impaired. Signs of blood-flow deprivation include pain, numbness, cramping, weakness of the fingers or toes, and blue or dusky-colored nails. Leave the bandage off until these signs are gone and consult your doctor. Rewrap the injured area but less tightly this time.

ELEVATION – Elevate the injured part at or slightly above the level of the heart. This is another way to decrease swelling and pain at the injured site. Use pillows or sit in a reclining chair. Be careful not to raise the injured part too high or rest you arm or leg on a sharp edge as this can impair circulation. Finally, do not use a rope or string to elevate your arm or leg as this can also impair circulation.

So if you have a new injury, remember P.R.I.C.E.!    And remember that ice should be used for at least 72 hours after the injury, and for more severe injuries should be used for 1-2 weeks.  As long as there is any inflammation use ice, not heat.   And as always, call your chiroprator if you have any questions.