During my 27-year-old private practice, many patients have asked me when they need to heat the ice. I always start the conversation, by stating some basic facts. The main use of ice is to reduce the swelling or inflammation, not necessarily to reduce the pain. Ice can reduce the pain by dulling or numbing the injured, but it is not primarily a pain reducer. Heat, on the other hand, has a calming influence on the most muscular skeletal conditions. Let’s face it, patients come to my office to feel better. However, if heat is used too early, it can actually cause more damage. Here’s why … let’s say you sprained your ankle. Is not it swell? What would you on a swollen ankle? Would you have a heating pad on a swollen ankle? I doubt it. Most people would use ice.
Well, if someone hurts your lower back, for example, the pain indicates that something is irritating. And if it is anger, there is a degree of swelling. PT’s usually more useful to the ice under these circumstances, because the ice reduces swelling. This is turn reduces the amount of pressure on the nerves of the lower back.
I remember many years ago someone told me the ice the first 24 hours after the heat. During my tenure, I have a different rule of thumb. Ice for as long as there is evidence of a swelling or pain. With any medical advice always consult with your personal physician to determine the best course of treatment for your specific condition.