Heat vs. Cold
It's a little funny that there is a debate on the use of heat and/or the cold in treating injuries, because both are tremendously useful. As with most things in life, beware people who say only use one or the other. Both are very effective at achieving certain results, and both should be used when appropriate. The following are some time-tested guidelines to help you in your decision of what temperature modality to use.
Cold is excellent to use on acute injuries. When you are injured, one of the body's responses is to produce inflammation. Inflammation is a good thing, but can get out of control and cause problems if left unchecked. Ice does not remove inflammation, but it does prevent too much from accumulating. A good rule of thumb is to apply ice for 30 minutes as often as every two hours for the first two to three days after an injury. Your body will still produce the necessary inflammatory response, but it will not get out of control. Icing longer than 30 minutes will have little extra effect.
Cold can also be used as a pain reliever. Initially ice or a gel ice pack feels cold. After a few minutes, the skin becomes numbed and we don't feel cold any more. This is the analgesic property of ice and can extend to structures below the skin. The pain of bruises, sprains and strains can all be alleviated by ice.
Crushed ice in a plastic bag is an excellent way to apply ice. Cubes are not as effective because of the small pockets of warm air that can collect between the cubes. If you have access to a crushed ice machine or want to take the time to crush the ice yourself, this will make the application much more effective.
Many people do not have access to or want to take the time to crush ice. A gel ice pack is an excellent alternative. A good gel pack will remain flexible even when frozen and work very well at cooling the desired body part. There is a common misconception that gel packs do not get as cold as ice, the truth is in fact, just the opposite. The physical properties of ice prevent it from getting colder than 32 degrees Fahrenheit. Even if your freezer is 10 degrees, the ice is 32 degrees. The gel packs freeze solid at very, very low temperatures. This makes them remain flexible when stored in any residential freezer, but also allows them to get much colder than ice. If your freezer is 10 degrees, the gel ice pack will be 10 degrees. This makes it very important to keep a small piece of cloth between your skin and the ice pack. A pillowcase works very well at allowing the cold to penetrate but protecting your skin against a nasty ice burn. The Sports Medicine Shop offers excellent gel packs. Visit the shop's web site section on hot & cold therapy for pictures, descriptions, prices and comparisons.
Heat should be avoided any time active inflammation is taking place in the area you wish to treat. Heat increases the inflammatory response and can result is negative side effects if used while the inflammatory process is still active. The inflammatory process starts when an injury takes place and generally subsides within two to three days. For those first two to three days, avoid heat. After the first three days, heat can be very useful.
Heat is an excellent pain reliever. Heat is almost always comfortable and can reduce pain significantly when used. Heat also increases local circulation and can help the body remove unwanted swelling. Heat is also excellent to be used for joints. The joints of the body all have lubricant, and just like the lubricant in your car engine, the lubricant works less efficiently when cold. Heating joints prior to activity can help reduce the amount of damage caused by athletics. Heat can also relieve joint pain associated with arthritis. For pain relief I believe heat works better than cold. The Sports Medicine Shop carries several excellent moist heat alternatives. Visit the shop's web site hot & cold therapy section for pictures, prices, descriptions and comparisons.
Moist heat will be much more penetrating and comfortable than dry heat. Heating pads that plug in often don't provide such moist heat. You can purchase plug in heating pads that provide a moist heat, but they tend to be very expensive. The heat packs The Sports Medicine Shop carries provide moist heat, require only a microwave to get them hot and are quite inexpensive. These packs absorb moisture from the air when not in use and release that moisture as well as heat when placed in a microwave for two to three minutes. They provide a very comfortable and penetrating moist heat without having to get the pack wet or spend a great deal of time in preparation.
For arthritis sufferers or people who want to heat the extremities, the Paraffin bath from Hygenic is just the thing. The paraffin bath melts paraffin wax mixed with mineral oil and keeps it melted. You dip your hands, feet, elbows or whatever into the bath to coat the skin with a warm layer of wax. Pull the body part out for a few seconds and re-dip to thicken the layer. Heat is very penetrating and the pain relief is remarkable. The mineral oil keeps skin soft and is excellent for dry cracking skin.