Hot or Cold?

One of the most common questions I receive is “Should I use hot or cold?” If you are injured and wonder whether to heat or ice it – everyone from family members to co-workers has an opinion on which to utilize.

In order to answer the question, let’s first understand inflammation in the body.  Inflammation is not an infection; it is the body initiating the healing process.  Today we are discussing inflammation in the context of acute and chronic injuries.  

The cardinal signs of inflammation are swelling, heat, pain, redness and possibly loss of function.  These symptoms would be considered acute and in this case ice (cryotherapy) would be required.  Typically applying a cold compress up to 20 minutes is acceptable, then remove and reapply after waiting another 20 minutes. Always make sure when using a cold compress that there is a barrier (towel) between you and the compress. You don’t want to end up with frostbite!

Most people have experienced an ankle injury.  Immediately following the injury the ankle becomes red, swollen and painful.  This acute situation requires a cold compress.  If heat had been applied in this particular situation the ankle would become further swollen and progressively more painful.  

Heat (thermotherapy) is generally used when dealing with tight muscles or an older injury that would be considered chronic. An example would be someone suffering with back pain over the years. It is not a new injury. And let’s face it, applying heat in any form (bath, Jacuzzi, shower, heating pad) makes us feel comforted; warm and fuzzy.

Often when we have a new injury, we may not see all the signs of acute inflammation. Perhaps there is only a little swelling and some heat coming from the area, but no redness and there is no loss of function.  In this scenario most people will apply heat. However, this is not always the wisest decision.  By subjecting that body part to heat you may in fact be increasing the inflammation, swelling and pain. For a few days cold is the way to go. One product I recommend is Biofreeze. It is a cold therapy that uses an herb rather than chemicals and can be applied while you are at work or on the go.

Every person and situation is different; consequently there are always exceptions to any rule. If you follow the basic principle of apply cold when you feel heat – you won’t go wrong.