Heat vs. Ice. It’s a long debated discussion amongst chiropractors, physical therapists, and medical doctors. Do you need ice or heat? Here are some tips. 

You cannot have pain without inflammation. Pain is actually one of four presentations of inflammation—the others being heat, swelling, and redness. Sometimes all of these signs are there. Sometimes, it’s just one or two. To put things in perspective, think of an ankle sprain. The ligaments have been torn. You then start experiencing pain, the ankle swells up, starts to turn red, and the area becomes warm.  All of these signs are actually the body trying to heal itself, while in the meantime, making us miserable. Ice will reduce all of these, and it is the most powerful topical anesthetic and there are no side-effects if used correctly! 

So when we are dealing with the joints in the spine, we have to treat it similarly, because really all joints are alike.  The biggest difference is that the joints in your spine are 1-3” below the skin so the swelling is rarely visible. This is one reason we offer electrical muscle stimulation and ice at Performance Health Center. Both are fantastic therapies for treating pain, inflammation, and muscle spasms! Once the nerves get irritated, the surrounding muscles can get inflamed too, or go into protective spasm! We see it all day long in our practice. Based on our exam, we can determine where the cause of pain is. Is it related to the disc, the facet joints, the nerve, or the muscle? In general, people seek out chiropractic care because they are in pain. And we ALWAYS recommend ice for pain control and inflammation.   

Ice should be moist so it penetrates. The best was to get moisture is to put a damp paper towel between the icepack and skin.  For the 1st 24 hours after an injury it is best to ice 15 minutes on and 15 minutes off and then repeat.  After 24 hours the protocol becomes 20 minutes on and at least 1 hour off and then repeat.

So where does heat come in? Patients always ask whether they should use ice or heat. Here is the issue with heat. When someone has pain and they use heat, it usually feels good in the moment, buy actually creates more inflammation.  Remember, heat is a component of inflammation. Do we want to add heat to an area that is already inflamed and hot?  It’s like putting fuel on a fire. We don’t.

When do you use heat?  The day after your overexert and you feel like you have used muscles you haven’t in a long time.  As long as the sore feeling isn’t at a joint (when ice is best).  Moist heat is best because it penetrates.  Dry heat literally dehydrates the muscles and bakes the skin.

Heat protocols are similar to ice- 20 minutes on, 1 hour off then repeat.

Moist heat is also great for muscle stiffness, but not muscle stiffness in the presence of pain. Some people just have tight muscles. This is when heat can be used therapeutically. Hot showers feel amazing, because the muscles loosen up. So if you want a great source of heat, even if you’re in pain, you’re best off taking a hot shower or bath. I often recommend doing some light stretching in the shower as well. Just to loosen up the muscles a little more.

Speaking frankly, I hate using ice. I try to avoid it as much as possible (because I am naturally always cold). But I avoid heat as well. My choice in cases where my pain is more moderate is Biofreeze.  Really it’s the next best thing to ice, at least in my opinion. The ice comes out when I experience pain that is really severe.

One last recommendation—magnesium! Magnesium is a natural muscle relaxer. It is safe and effective without any of the weird side effects or interactions! We carry Metagenics Magnesium Citrate and Magnesium Glycinate—both excellent for muscle spasm! If you have any questions about these supplements, ask one of the doctors or our knowledgeable front staff! We’d be happy to guide you in your specific needs.  For more information email me at: [email protected]