Ice or Heat - "Which Should I Apply?"
Medical Author: William C.
Shiel Jr., MD, FACP, FACR
Medical Editor: Leslie J. Schoenfield, MD, PhD
cold or heat for conditions involving the muscles or joints has been used for
centuries. These temperature applications have been available without a
prescription since early man ventured up and over snow-capped mountains and
slipped down into soothing natural hot springs. Cold/ice and heat applications
are also used today as standard medical treatments throughout the world.
However, since they are obviously opposites, when are they best used? And when
could they cause problems rather than be helpful?
This article will focus on the use of cold or heat applications for musculoskeletal
conditions. It does not address the treatment of other conditions, such as burns or infections.
What happens to the tissues
after an injury?
When a runner "pulls a
groin" or a tennis player "strains a tendon," the soft tissues in the area
of pain are injured. Immediately after the injury, there are disrupted fibers of
the affected muscle, tendon, and/or ligament. Additionally, the tiny blood
vessels (capillaries) that normally supply blood and oxygen to these tissues are
broken. The broken capillaries then leak varying amounts of blood and serum into
the adjacent tissues. Therefore, soon after a soft tissue injury, localized
swelling occurs. The injured tissues become painful and tender, both directly
from the trauma to them and indirectly from the subsequent swelling. This leads to the stiffness, pain, and tenderness that so often accompany the inflammation of tendinitis, bursitis, as well as strain and sprain injuries. It should
also be noted that even a bone injury (such as a fracture) is typically
accompanied by injury to the nearby soft tissues.