In this corner, weighing in at 57.2 pounds per cubic foot, with a record of 10 wins and 10 losses with all 10 of those wins due to frostbite, IIIIIIIICE! (Ice enters ring to the sound of “DUN DUN DUN DUDDLE UN DUN” If you are not sure what the hell that was, it was the 80’s song by Vanilla Ice. C’mon, you should have sounded it out and it would have come to you.) And in this corner weighing in at 1000 degrees, with a record of 10 wins and 10 losses with all 10 of those wins coming by way of it’s signature move the FLAME-URA, HEEEAAAAAT! (Heat enters right to the sound of “DUN DUN – DUN DUN CHI…DUN DUN – DUN DUN CHI” Did you get that one? Might be a little stretch but with all the clues you should have gotten The Power Station, “Feel the Heat” intro. This topic is ssoooo compelling, I had to summon all my powers of onomatopoeia and imagery to excite the crowd. Excited?! Yeah, I didn’t think so. Well here goes everything.
It has been surmised that ice is preferred for inflammation control and it useful in the first 24 to 48 hours following an injury. Heat is better for muscle relaxation and has an inflammatory effect which is useful after the first 48. Not the TV show but an injury. The developer of the acronym “RICE”, with the letters standing for Rest, Ice, Compression, Elevation has recently waffled on his original stance. All research leads to the fact that ice has no effect on inflammation what so ever. The reason ice feels good after about 10 minutes is because it has an anesthetic effect. It essentially numbs the area. Good bad or indifferent, if pain is unmanageable, go ahead and ice it. I’m a big fan of comfort. Just remember that ice should not be placed directly on the skin and a thin towel, even a paper towel is enough to prevent ice burns which suck. But truly, the REST, COMPRESSION AND ELEVATION will help to control the inflammation more than anything else. Realize this, inflammation is not bad, especially when speaking about a traumatic injury. It is necessary because of the cascade of healing events that occur. In fact, when someone comes in and we perform many of our techniques, our goal is to create a “controlled inflammatory response” to re-initiate these healing events. Sometimes the inflammation from a trauma causes excess pressure which is painful and the pain response is what freaks us out. Ice baths are still widely used in top level athletics even though there is no concrete empirical evidence to show that it has beneficial effects. Yet another reason to sometimes accept the anecdotal evidence.
Heat on the other hand, brings blood flow to an area. Muscles always experience a palliative or soothing effect from the application. We used to say that heat may feel good initially but in a couple of hours post application, you have have an increase in pain. This is true but the increase in pain is usually temporary and fleeting. I remember when I was dealing with a low back issue and I had symptoms that were radiating into my leg, I was placing heat on my low back and slept in a recliner for a couple of weeks. There is no way that the heat was penetrating deep enough to have an effect on the disc but it was certainly calming down the tight muscular component that is typically associated with a disc issue.
Unfortunately there will be no great take-away from this blog. Only factual information that will help guide your decisions. The record of Ics vs. Heat is a stalemate and will continue to be so. At this point in time, Ice is losing a little steam (Ha – get it?) but new research comes out monthly and it always seems to contradict the latest discussion. If I were a betting man, and I am, I would put 1/2 my money on Heat and 1/2 on Ice. You can’t lose.