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The application of ice to an injured area as shown in this picture of former Malaysian badminton player Datin Wong Mew Choo, is known to reduce inflammation and pain. — Photos: Filepic

Should you apply ice or heat for pain relief?

Pain is a critically prevalent feature in injuries and prolonged medical conditions. Good pain relief is necessary for your well-being.

Two very simple yet effective methods are the application of ice and heat but there can sometimes be confusion over it’s best use.In general, when to use ice or heat depends on the kind of pain you are experiencing.

In this article, we will look at the pros of these treatment together with cases where a mix might end up being much better to manage pain and enhance comfort.

Benefits of ice therapy

A cold compress can also help with toothaches as it numbs the nerves to relieve pain. — Pexels

There are ice-packs and cryotherapy (ice therapy), which is a tried-and-tested method for relief of pain and inflammation. This method includes the targeted application of cold to a specific area, which results in many therapeutic advantages that could notably speed up healing.

However, research from the Journal of Athletic Training showed that using ice immediately can reduce swelling by up to 30%. Ice works by:

> Reducing inflammation: Ice therapy works by decreasing blood flow to the affected area, which diminishes inflammation processes that would occur if you keep the area warm. In doing so, it prevents too much tissue damage from an ever-increasing inflammatory response.

> Numbing pain: Ice has a local anaesthetic effect, and slows pain signal transmission to the brain. This approach instantly eases acute issues such as sprains and fractures, making pain medication unnecessary.

> Decreased metabolism: Chilling slows down cellular metabolism and therefore reduces tissue damage post-injury.

How to apply ice therapy

If you try ice the wrong way (yes, there is such a thing), it will lose its effectiveness.

> Ice: Commonly used to soothe sunburn, ice must always be wrapped in a towel (never placed directly on the skin) and can be in the form of cubes, pebbles or ice pack. Apply for 15-20 minutes.

> Ice baths: Ideal for larger surfaces and frequently used by athletes, this practice leaves the affected body part immersed in cold water to reduce inflammation and pain after intense activity.

> Ice massage: Massaging the injured part with an ice cube or slush helps reduce local inflammation.

> Cryo chambers: When you step into these medically-controlled chambers for a few minutes, the dry, super cold air penetrates into your skin. It has an anti-inflammatory and analgesic effect.

Whichever method you opt for, do not leave the ice on for too long as it may cause tissue damage or frostbite. Ice needs to be applied at intervals in conjunction with breaks to allow the pores and skin to recover.

Benefits of heat therapy

Unlike cold, heat therapy – also known as thermotherapy – utilises the healing benefits of warmth to reduce pain and support recovery. Key benefits include:

> Muscle relaxation: Warm therapy relaxes tight muscles by widening the constriction of blood vessels, revving up bloodstream supply plus reducing spasms as well and calming sore muscle tissue. It relaxes muscles by speeding up recovery from muscle strains and stiffness due to exercise or sitting for a long time.

> Increased blood flow: Heat also stimulates blood flow, which can oxygenate damaged tissues and speed up the healing process. It also helps eliminate metabolic waste which then helps alleviate pain from chronic conditions like arthritis by reducing stiffness and increasing movement.

Types of heat applications

These include:

> Dry heat: Examples include heating pads and infrared saunas (to increase sweating). Provides easy and fast relief.

> Wet heat: Simply soaking in warm water or placing a moist, steamed towel over the affected area offers deeper penetration and requires less time to soothe.

> Hydrotherapy: This is where the body is heated through water. The most common forms of hydrotherapy are hot tubs, whirlpools and warm water exercises.

By utilising a combination of the healing heat and buoyancy of water, there is less strain on joints and muscles, giving you an overall relaxation experience that assists in pain management.

> Paraffin wax treatment: Good for hands and feet, warm wax is coated lightly to reduce joint pain. Heat therapy is an adaptable way to alleviate pain and encourage healing.

When to use what?

Infrared saunas help improve blood circulation and soothe sore muscles.

Knowing if you should apply ice or heat in certain situations may help your pain management strategy. They all have different benefits for certain types of injuries and conditions.

> Acute injuries: Ice therapy is good for all sudden injuries such as sprains or bruises.

Blood vessels are narrowed and pain is dulled during the first 24 to 48 hours while inflammation decreases. Use ice in 15-20 minute intervals to avoid frostbite.

> Chronic pain: People who have chronic pain from arthritis or old injuries can derive a lot of benefit from heat therapy. It relaxes tissue allowing for increased movement and blood flow. However, do make sure the temperature of the heating pad or warm towel is not hot enough to cause a burn.

> Combination therapy: In other cases, both ice and heat can be applied together to get the best results i.e. contrast therapy. For example, athletes may start off with ice for quick inflammation relief and then move on to heat a few days later.

Conditions such as tendonitis respond well to combination therapy in which ice and heat are used alternately, extinguishing the pain-spasm cycle while speeding up recovery. Contact your healthcare provider to find out what’s the best approach for you.Conclusion

Using ice and heat to treat an injury is one of the oldest forms of pain management, having been used thousands of years ago in ancient civilisations like Greece, Rome as well as Asian societies. Ice therapy is highly effective for inflammation reduction as well as numbing of acute pain, thus great after new injuries or surgical recovery. As mentioned above, there are many ways in which the individual can seek immediate relief from swelling and sharp pain via icing methods.

In contrast, heat therapy comes in handy when you are looking to relax muscles and relieve chronic pain. For persistent soreness, heat exposure can help. Basically, ice is best for acute injuries and sudden flare-ups while heat helps with chronic conditions and muscle stiffness.

In some instances, you need to alternate between the two to hasten recovery. Knowing when ice is helpful and when heat can be effectively applied can make every day living with pain more manageable, especially for seniors.

By using these tried and trusted treatments, you can take pivotal steps toward recovery and improve your quality of life.

By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper, 23 Sep 2024

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