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At least one time a day I will have a patient ask, “Should I use heat or ice?”

In school the, “heat or ice” topic was addressed early on. We were taught to use ice for the first 3 days and heat after that.  The idea was that the ice will cause the blood vessels to close, decreasing the blood flow to the area, and decreasing inflammation and swelling.  In contrast, heat will open the blood vessels, bringing more blood and nutrients to the area, allowing for faster healing.

In the past few years I have changed my stance to, “Do whatever feels good.”

The reality is, nobody’s primary problem is that they didn’t use enough heat or ice.

By using these, you are treating the effect of the actual problem.  The inflammation is the effect of joint or tissue damage and is necessary for proper healing.  So you really don’t want to mess with it.

The temperature change necessary to open or close the blood vessels usually does not  occur deep enough to get the desired effect to the place you actually need it, your damaged joint.

I see the use of heat or ice as beneficial purely for pain control.

Heat decreases pain for most people because it feels good and can help muscles relax.  Ice numbs things and as a result, will help you not feel as much pain.

The important point I want to get across is that ice and heat never address the root cause of your problem.  So if you plan on using whirlpool baths, saunas, or cryotherapy chambers these things may feel good, but just like medication and cortisone shots, they do absolutely nothing to fix your dysfunction.

Ice can be beneficial at reducing superficial swelling that occurs with ankle sprains, direct trauma, etc., but that is about it.

Instead of wondering about using heat or ice, focus on getting a complete and accurate diagnosis, an understanding of why you have your symptoms, and on decreasing the load you put through your injury so that healing can occur.

Dr. Andrew Wengert is trained in the most advanced conservative care treatments for correcting problems in the muscles and joints, and offers the clinical excellence you need to recover. 

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