(Updated 2017)

 

This is a fairly complete guide, for an issue that “should be simple”.

It is not.

And this is a subject worth understanding, because you will probably need this information several times in your life.

Reading this guide will help you make better informed decisions when trying to limit pain and accelerate healing, while limiting the risks and side effects of pills or injections.

 

COLD: A NEW PARADIGM

For years, this article had the traditional and almost ubiquitous information: cold helps to lower inflammation and pain and helps in the recovery process.

But this paradigm is shifting in the world of rehabilitation …

In principle, because although putting ice on injuries has been a common practice for over 40 years, there is little evidence to support its effectiveness.

In fact, there are many studies that prove the exact opposite!

This does not mean that cold does not help reduce pain. The problem is that by reducing the pain we could also be extending the recovery process, which makes the pain last longer…

 

HOW COLD MIGHT DAMAGE

I know, it’s hard to believe, especially since most professionals still prescribe ice.

But for example, this study showed that markers that help the body heal decreased in subjects who applied ice. This study showed how applying ice did not help foot sprains at all.

Experts believe the primary reason for this, is that inflammation helps to heal.

Inflammation gets a bad rap, mainly because our society might be suffering from an epidemic of too much inflammation, both in the form of autoimmune diseases, and systemic inflammation that leads to cardiovascular disease (among other problems). 

But those are examples of the body generating inflammation without trying to heal anything. And even though cold compresses can help reduce pain, sometimes even for those suffering from autoimmune diseases, cold can often be counterproductive.

This means that even taking anti-inflammatory drugs, although sometimes necessary to “survive” through the pain, could also delay the healing process. There are theories that ice could reverse the lymph flow in a way that would worsen your injury.

In addition, delaying the healing process involves a greater risk of re-damaging tissue.

Which is why more health care professionals are recommending, when possible, to let the body use its intelligence and natural processes of repair … that means allowing inflammation to occur in the site of the injury.

 

This does not mean that more inflammation than the body naturally produces is a good idea either… Which brings us to heat.

HEAT: HELPING TO HEAL AND CALM

There are three specific ways heat can help you:

1) Heat helps to relax muscles.

This is important not only in the affected area, but also in the surrounding muscles, which are typically contracted from overuse (they are over-working  to compensate for the injured muscles).

2) Heat increases blood flow and metabolic activity.

Taking into account that the body heals primarily by using the blood to bring repair mechanisms and carry (along with lymph) waste byproducts, increasing heat can aid the healing process.

3) Heat can decrease pain.

Heat stimulates the skin’s receptors, and this in turn reduces pain messages that go to the brain in the same area. The theory is this: since the brain can process only a certain amount of sensory information, it reduces pain information in order to process heat information.

To apply heat, you can use hot water bags or an electric heat blanket.

There are people who prefer towels with hot water – they work, but they lose heat fast. Others prefer a bath with hot water: this can work very well, as it can also help you relax the body, as long as you can be comfortable during the bath (and are comfortable with the ecological repercussions of running water for a long time).

WHEN NOT TO USE HEAT:

As I said before, the body’s natural inflammation is positive. But overdoing inflammation is not good. Therefore, avoid heat in these cases:

  • During the first 48 hours of injury
  • When there is little circulation due to an illness
  • Edema (swelling)
  • Cardiac conditions
  • If you have problems feeling temperature changes
  • Infections
  • Burns

FINAL NOTE:

Remember to use precautions so that the heat is not very intense, and do not do it for more than 15 to 20 minutes in a row.

Let the area rest for the same numberof minutes you used the heat before re-applying.

While reducing pain and inflammation may not seem to directly fix the problem, having too much pain in an injury site for an extended period of time can mean your body begins to compensate in ways that can become more permanent. Furthermore, painful signals can also become chronic, even when the pain has gone away.

Therefore, dealing with pain is an important part of the healing process.

For a holistic and lasting solution to your pain,

Michael