Should I use ice or heat?

Benefits of hot vs cold for an injury.

Perhaps you've had a twisted ankle, sore elbows from another day at that desk, or stubbed your toe in the middle of the night.  A bucket of ice is painful and it's just too difficult to sleep under a hot shower.  What should you use to help calm symptoms of pain and swelling while increasing healing time?  Let's look at the physiology of your body:

Ice

Advantages:

• numbs skin sensations by slowing nerve conduction
• overwhelms nocioceptive input from region (part of a pain signal) which limits sensation of pain
• limits inflammation and swelling by constricting blood vessels thus reducing blood flow

Disadvantages:

• limits inflammation--wait, what?--yes, inflammation is part of a healthy immune response to injury.  The body will heal best with optimal amount/timing of inflammation, not a removal of it.
• slows delivery of oxygen and nutrients by reducing superficial blood flow

Heat

Advantages:

• promotes blood flow which increases delivery of oxygen and nutrients
• blood flow to superficial nerves often relaxes and calms pain symptom

Disadvantages:

• may increase inflammation in acute injury
• may aggrivate and increase sensations of pain

Conclusion:

• In general, injuries respond best to ice in the first 72 hours as the initial stages of inflammation are still taking place.  After 3 days, do what feels best to you.  Each persons body may respond differently to heat or ice.
• Restrict either to 20 minute intervals with at least 20 minutes of rest between.  You body needs time to restore normal temperature to superficial tissues.  Avoid ice or heat if it adds great symptom increase.
• Both ice and heat affect maybe 2 cm deep.  They are used to help you feel better, not as a cure all.  Hands and feet are the most affected tissues by ice/heat because they are thin enough to change temperature.  The causes of low back pain are rarely altered by temperature change, though your symptoms may be helped.

All injuries should be evaluated by a medical professional.  Feel confident that ice or heat may be a great part of helping you heal and feel better.