Dr. Capri, should I use heat or ice?
As a muscle & joint pain specialist, I get asked this question very, very often! And my answer tends to surprise people: “No! You shouldn’t”
I know... I know. We have all heard since the late 1970s that when you have sore, strained muscles or a sprain (like a sprained ankle), that you should use ice to get all of that “nasty” inflammation out of there! And those who don’t like the ice will use heat! And I get the thought process. I do. But just because you can understand the idea behind something, that doesn’t make it right.
When there is damage to a piece of you (like a muscle or a ligament), your body rushes blood to the area, as the initial stage of healing. This is why the area feels and often looks swollen. The use of ice & heat is all about controlling blood flow.
When temperature rises, your blood vessels widen, which increases blood flow.
When temperature lowers, then your blood vessels get narrower, which decreases blood flow.
Ice is used, mostly, to reduce inflammation, and if you go through the 4 stages of cold, then you will also get the pain to go away for a while! And that is the only way that I recommend you use ice: to take the edge off of the pain if you have to! Otherwise, I say do not use ice for a sprain or sore muscles!
Heat, meanwhile, helps stiff and sore muscles by bringing blood flow to the area, making them more relaxed and ready to move. And, let’s face it: heat just feels good!
But let’s think about this for a minute, shall we?
The first stage of healing is called inflammation. This means that by trying to stop inflammation with ice, you are fighting against your own body! Research tells us that icing slows down and delays healing! Research also suggests that icing sets you up to have chronic pain later!
Muscle is “reactive tissue”. meaning that it is rarely the problem, but it usually is trying to help with the problem. So, when your joints are taking too much of a load, it is usually because the muscles that are supposed to support the joint are not doing their job. So, the joints need help from muscles that cannot do the job under regular circumstances. So, they tighten up, to try to anticipate the problem. If they are tight, and you use heat to loosen them, what happens? The joint is taking on too much stress again, because you have forced the muscles to stop “helping.”
Who knows better: You or your body?
It doesn’t matter which way you lean, either:
Do you believe in the Theory of Evolution? If so, then you are telling the body that you know better than millions of years of it learning to protect itself
Do you believe that there is a God who created us? If so, then you are fighting against the way the body was designed to heal itself.
The RICE Method for Sprains & Strains is Outdated!!!
The RICE method (rest, ice, compression, and elevation) has been a common method of treatment for sprains for many years (the phrase was coined in the late 70s). Even the doctor who came up with the term has admitted his error.
Rest: Rest doesn’t mean “do nothing!” Rest means to “listen to your body and take it slow and easy.” BUT you NEED to move it! Movement is the body’s way of getting rid of the inflammation that it doesn’t need. So, for instance, if you have a sprained ankle, stop jogging! But, take your ankle and draw the alphabet with big capital letters every hour.
Ice: No! Just… no.
Compression: Again, this is mostly to stabilize and help to control inflammation. It’s mostly unnecessary, and I don’t like it for the same reason as ice. Let the body do its thing!
Elevation: This is meant to use gravity to get the extra fluid out of the sprained area, and back to the heart. You don’t need this.
OK, since I mentioned it...
If you need to take the edge off of the pain, then you can use ice. Just make sure you go through the 4 stages of cold.
The 4 Stages of Cold
Stage 1: “Holy crap that’s cold!” (the 1st couple minutes)
Stage 2: Burning/stinging (minutes 2-8)
Stage 3: Decreased pain perception (minutes 8-16)
Stage 4: Numbness (minutes 16-25)
(Times are approximate)