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This has to be one of the most frequently asked questions in our practice. In my opinion, I have always advised on using ice over heat for acute injuries. Applying heat to an affected area, when you should be applying ice could make your injury a lot worse. This is why it is imperative to understand when we should be applying ice rather than heat. 
When we suffer an injury, the body tries to protect itself by creating inflammation to help it heal. If you notice, the affected area is generally warm/ hot from the inflammation. So applying heat to the affected area will make it worse, by increasing the inflammation which could lead to more tissue damage. If a patient presented with pain and discomfort, especially in the first 72hrs, we would always recommend using ice. We would recommend using an ice pack, wrapped in a light tea towel on the affected area 3/4 times daily, 15-20 minutes a time. The main reason for this would be to reduce inflammation, tenderness and swelling from the surrounding area. Ice does this by constricting blood vessels, which inhibit the body from allowing inflammation to the iced area. 
Heat in the other instance, we would normally recommend once the pain has subsided, to improve circulation and relax the muscles. It would be best to use heat, when symptoms are more of stiffness and achiness. This would be approximately 2 weeks after an injury and again, we would always recommend using a heat pack/ hot water bottle, wrapped in a tea towel over the affected area for approximately15-20 minutes, 3/4 times daily. It is always important to use a covering over the ice/heat pack to avoid burns on the skin. In some instances, especially with certain medical conditions, neither heat or ice would be suitable. 
Harish Kapur DC 
Tagged as: Injury
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