Chiropractic & Physiotherapy

Ice or Heat For Pain?

Pain is a factor that drives most of our clients to consult us here at Healthworks, be it acute (less than 3 months) or chronic (more than 3 months). One of the adjunct treatment that we commonly use are the ice or heat pack. And the usual question was “when should I use heat or ice?”. To maximize a particular treatment, we must first understand the underlying physiology of the particular injury.

Acute pain is due to tissue damage and most commonly caused by trauma. In most circumstances, acute pain is self-limiting and proportionate to the degree of injury sustained. After damaging a particular body tissue, the body will then illicit an inflammation cascade inducing localized pain, swelling, reduced range of motion, and tenderness to touch. The better treatment option would be using ice to treat such injuries is to alleviate pain, reduce tissue metabolism, and to restrict swelling.

Pain will usually become less severe as the injury heals. However, chronic pain is different from typical pain. With chronic pain, the body continues to send pain signals to the brain, even after an injury heals. This can last several weeks to years. Chronic pain can limit mobility and reduce the flexibility, strength, and endurance. In this case, heat would be a better option for treatment where it helps with soft tissue flexibility, muscle resistance, easier and better contraction of smooth muscles, and improvement in the muscles’ motor function. Besides, heat therapy triggers decline in pain especially low back pain through stopping pain signal and exerting pressure muscles.

However, recent updates have shown that heat can be treated for acute cases. 87 patients randomly assigned to three (thermotherapy and cryotherapy as intervention, and naproxen as control) groups of 29 each. The first (thermotherapy) group underwent treatment with hot water bag and naproxen, the second (cryotherapy) group was treated with ice and naproxen, and the naproxen group was only treated with naproxen, all for one week. All patients were examined on 0, 3rd, 8th, and 15th day after the first visit. In this study, thermotherapy patients reported significantly less pain compared to cryotherapy and control.

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