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Heat or Ice?


A frequently asked question is ‘Should I use hot or cold?’ 

By rule of thumb always use cold therapy on achey joints, unless you are sure what is injured or have had professional advice. If you have back or neck pain which is achey, nagging or dull, then it is likely that it is caused by a degenerative process that creates heat itself. If the pain is sharp, knife like and shooting then structures such as discs may be involved. If the pain is hot and periodic (comes for a few weeks and dissappears for a month or so) then this is liekly to be an inflammatory process. The discs between our vertebrae have a soft centre with elastic rings around the outside, a bit like a soft centred sweet surrounded by a chewy outer, that soft centre is like petrol on a fire when it comes in contact with the nervous system and creates heat and intense, sharp pain. Ask yourself, would you really want to put more heat into an already inflammed area? No! There…. the question is answered!

Research was carried out at Cardif university (circa 2000) where they compared similar groups of patients of similar age, with similar low back pain and monitored their progression. They had one group to use ice and another to use nothing and compared how the patients recovered. The study found that those who used ice, even if they did not report a decrease in pain, healed more quickly. So there are 3 reasons to use ice :-

1. Reduce and contain inflammation processes

2. Promote healing

3. Reduce pain

They also looked at the best way to use ice and discovered that ice had a greater effect if the area being treated had time to thaw a little within the treatment period. So the best way for low back pain is to use a bag of frozen small vegetables from the freezer, or a treatment intended ice pack; wrap it in a thin tea towel; place on the affected area for 10 mins, remove for 10 mins and then replace and remove a further twice (so 3 times with ice on the area in one session). This would equate to one dose. Repeat 3 – 4 times in the day.

For the neck and upper back do the same but for 5 mins each on and off. You need to adjust this a little if you are rather more solid but don’t exceed 20 mins.

COLD should NEVER be used over a pregnant tummy, front of a chest, or during a time when the patient has a chest infection on the upper back. If your surroundings are chilly, then make sure you are wrapped up warmly so as not to catch a chill. Elderly and frail patients should seek advice first.

HEAT does have its place. Heat is good to increase circulation. So in cases where you have strained or sprained a joint such as a twisted ankle and there is almost instant swelling and or bruising (so long as you have not broken the underlying bone) then heat is good. For joints such as an ankle in a similar way 5 mins on, 5 mins off and repeat a further twice. To speed the healing process you coukld do both HOT AND COLD so instead of removing the heat and leaving the joint replace it with an ice pack for the same pattern. ALWAYS end on cold though.

This advice should only be adopted for a short period of time whilst you seek professional advice.

If you are still not sure which therapy is best for you, then please contact us 01733 254239 or e-mail greenacreschiro@gmail.com.

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