For acute injuries (up to 3-4 days post injury) it’s best to apply ice. The reason being, injured soft tissues release several inflammatory compounds, some of which cause swelling and pain. Your body may overproduce these compounds after an injury, making it more painful than necessary. Lowering the temperature (icing) helps reduce the swelling by making blood vessels contract. Lowering the temperature also has an analgesic effect (lowers pain).
The proper method is to apply an icepack to the area (place a thin towellete between the icepack and skin to prevent iceburn), hold it down with Ace bandage (applying a mild compressive force), and let sit for 15-20 minutes. If your injury is on a limb, like your wrist or ankle, elevate it as well (so that it’s above your heart– lying down or sitting). Do this every two hours each day, up to six times a day.
When the swelling has gone down somewhat or after 4 days, try applying moist heat in between icing. Using a hot water bottle (with water heated to 150 degrees on your stovetop) wrapped in a folded, damp hand towel works well. Leave on for 15 minutes. Make sure to avoid skin burn by adding extra layers of towels as necessary. Heat will expand blood vessels and bring oxygenated blood to the injury site.
Dan Perez, DC
415.627.9077
