What should I use on my pain, ice or heat?

 

That's a good question. When deciding whether to use ice or heat there are a few things to consider. You should consider what is the root cause of the pain and where is it coming from. Let s look at what ice and heat do in the body, then we can consider where we should use each.

 

Ice

Ice causes a decrease in circulation. This helps reduce inflammation and pain but can slow healing. The application of ice to the human body decreases circulation through a process called vasoconstriction, which is the narrowing of blood vessels. Here's how it works:

1. Vasoconstriction: When cold is applied to the skin, the blood vessels in the area constrict, or narrow. This reduces the flow of blood to the affected region, which slows circulation.

3. Reduction of Swelling: By slowing blood flow to the injured area, ice helps reduce swelling and inflammation, which are natural responses to tissue injury. Decreased blood flow limits the movement of fluids and white blood cells to the area, reducing the buildup of excess fluid.

 
Numbing Effect:

Cold temperatures also numb nerve endings, reducing the sensation of pain. This analgesic effect is one reason ice is used immediately after an injury, such as a sprain or muscle strain.

 

4. Prevention of Further Damage: Slowing circulation with ice can prevent further tissue damage immediately after an injury by reducing the metabolic rate of the cells. This minimizes the amount of oxygen the cells need, which can help prevent cell death in the area.

 

 

Heat

Heat causes an increase in circulation. This helps with healing and recovery, but it can also increase pain and localized inflammation. The application of heat to the human body increases circulation primarily through a process called vasodilation, which is the widening of blood vessels. Here's how it works:

 

Vasodilation:

When heat is applied to the skin, it causes blood vessels in the area to expand. This widening of the blood vessels allows more blood to flow through them, increasing circulation. The increase in blood flow brings more oxygen and nutrients to the tissues, helping with healing and relieving muscle tension.
1. Thermoregulation: The body tries to regulate its internal temperature when exposed to heat. To dissipate heat and cool down, the body sends more blood to the skin's surface, where heat can be lost through radiation and evaporation (sweating). This is why applying heat to an area can result in increased blood flow.
2. Relaxation of Muscles: Heat also relaxes muscles by reducing tension. When muscles are less tense, blood can flow more freely through the tissues, further enhancing circulation.

4. Pain Reduction: The combination of increased circulation and muscle relaxation can reduce pain by decreasing the sensation of pain signals and by flushing out waste products like lactic acid that build up in muscles.

 

With this information at hand let s look at when and where we should use ice and heat.

Ice s ability to decrease inflammation makes it effective in reducing swelling in joints. I typically recommend using ice in conjunction with heat. The ice is applied to the swollen joint and heat is applied to a large muscle or muscle group distal (farther away from the heart) to the swelling joint. An example of this would be icing the sacroiliac joint and applying heat to the gluteal muscles. Since the gluteal muscles are a large muscle group and they are farther away from the heart the increased circulation in the gluteal muscles will help to push additional inflammation away from the sacroiliac joint.

 

I typically recommend heat on sore or healing muscles. The heat s action of vasodilatation will help the sore or healing muscles metabolize better. This means that the muscles will be able to pull in nutrients and get rid of toxins more efficiently. This process helps with the overall speed and effectiveness of healing. Care should be used though since this increase in circulation can also increase pain and tenderness in the area.

As a reminder you should always use care when using ice or heat. It is possible to burn the tissues with either. The use of ice and heat together can increase the risk of burns since sensation can be dulled with the use of ice.