Heat or Ice??

Heat or Ice??

The question of whether to heat or ice is one we as physiotherapists get frequently. And the answer for the most part is actually quite simple.

Despite much discussion about the theory of both heat and ice either increasing or decreasing inflammation, bloodflow etc., there is not much scientific evidence that either will help your healing in the long run. Therefore, my most common answer is “Whatever alleviates your pain.”

There are, however, a few situations where I do have specific recommendations:

1. Many continue to recommend ice for the first 24-48 hours after injury to reduce inflammation (see my previous blog on this topic). This also up for discussion, but it is a situation that I continue to recommend ice rather than heat as there is no downside to icing in this situation.

2. I also never recommend heat to an already hot or swollen joint. This might be a result of osteoarthritis or a recent surgery. If a joint is already hot, there is no need or benefit and it may even be deleterious to add heat to it (although many arthritis sufferers prefer heat – and if after years of suffering this is what makes you feel better – you know your body best!).

3. You have been icing a tendon for ages to no avail. Try heat! There is evidence that with chronic tendinopathy, there is actually no inflammation present (hence the name change from tendinitis to tendinopathy). That combined with the fact that tendons have very poor blood supply lends to the idea that chronic tendon injuries may respond better to heat (which increases blood flow to the area).

As always, thanks for reading!


Images courtesy of google images.

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