The Heat Versus Cold debate

The easy answer is, "ALWAYS COLD...... unless you have arthritis."

Usually by the time you have pain, your body has accumulated enough inflammation and "toxic soup substances" to elicit your body to respond.  So it's more than your normal, "typical" system can handle.  As a result, you have to take off the stresses and give it a chance to reabsorb back into the body, or else find a way to suck it all out of your body, i.e. needles and syringes (which is not always a fun experience.)  With cold, you can numb the pain away, decrease the blood flow to the area to stop the "toxic soup substances" from invading the damaged tissue (vasoconstriction) and sometimes even distracting an injury, thus allowing your body to begin reabsorbing the "bad things".

Heat, on the other hand, is a vasodialator, which means the (blood) vessels increase in diameter allowing for more blood and other substances to enter into the injured area.  Now, sometimes that is a good thing, but other times it is not.  If at the time, it makes you feel better, the odds are that it's working from a nerve stimulation standpoint, or "gate theory" for pain control.  I can bet you 80-90% of the time, the next day, the pain was about the same or worse.

Another factor to consider is how acute, or recent, the injury or pain started.  If it has been less than 2 weeks, definitely ice...... and even if it's been up to 6 weeks, I'd say ice more than heat, because the healing process is still in progress.  And if it is still a problem after 8 weeks, then a trained professional should really take a look at it and diagnose it to get the proper medical treatment.

COLD/ICE PACK TIPS:

1.  If you're using real ice, make sure you have at least 1 thin to medium thickness towel or sheet between the ice and your skin.  You don't want to run the risk of getting an ice burn, too!!  Old pillow cases work wonders as a barrier layer.

2.  Ice should remain on the injured area until it feels numb.  With a smaller body part, it may take less time versus a larger body part, i.e. wrist versus knee.  You will most likely experience 4 sensations when you apply the ice pack...... First, it will feel COLD; followed by STINGING, then BURNING; the last stage is NUMBNESS. At the point, you can take the ice pack off because anything more will do no good.  This process usually takes anywhere between 5 to 20 minutes depending on the body part.

3.  If you're low on money and need an easy solution, look in your freezer and just like the cartoons, grab the nearest frozen steak!!  Just kidding...... but do look in your freezer and look for some frozen veggies, preferably peas, corns or cubed carrots just because they all mold easily to most body parts.  Once you're done with them, just throw them back in the freezer.  Just be sure to label it and remember not to eat them.... (unless you really want to).  

4.  People with circulation issues or difficulty with sensation should NOT use ice!!!




Hope this information is useful and helps everyone make a better decision.  Please give me feed back and/or other ideas to write about!!!  Thanks for reading......

Dr. J Wong