Question: When should I use ice or heat?

Have you ever asked this question before? Notice what one chiropractor recommends:

A: Ice! Only occasionally, you can use heat.

Wh? Notice what he goes on to say:

When your back pain flares-up, it is inflamed. The muscles, joints, ligaments and nerves will become irritated and swollen. This is the time that you use ice. Ice has anti-inflammatory effects, which reduce the local swelling. As the inflammation decreases, so will your pain.

This is why anti-inflammatory medications are so popular and widespread. These are prescribed regularly on an ongoing basis for people for joint and muscle pain because inflammation is the first response by your body.

When you first put ice on your back, it may actually cause more aching and burning before it becomes numb. Patients are often alarmed by this and worry that their condition is worsening. Actually, this is a normal response and lasts about 5-10 minutes. We recommend using ice for 20 minutes at a time every hour or two. In other words, if your pain is rather severe, you can use ice for 20 minutes on, then 40 minutes off then back on again for 20 minutes. You can repeat this multiple times in a day. We recommend that you ice three or four times for moderate pain and up to 10 times for severe pain.

When you apply the ice, do not put a thick barrier between the ice and the skin. You simply want a thin dishtowel or paper towel to simply protect your skin. If your skin is particularly sensitive, you can use Vaseline on the skin as a second barrier. The one big problem with repeated ice treatments is burning your skin. This will happen if you put too much pressure on the ice pack and drive this into your skin. Simply lay it on your back or on the painful joint.

It doesn’t matter what type of ice you use. You can use ice cubes in plastic bags. You can use gel packs that mold around the area. You can actually use frozen peas or frozen corn.

How long should you apply ice? Depending on your particular episode, the inflammation may last much longer and not be resolved in one or two days. It is not unusual for us to keep someone on ice for two to four weeks before all the inflammation is gone.

When you are done you can then do 20 minutes of moist heat to loosen up tight muscles. Don’t do this more than 3-4 times a day, and remember…only after icing.

If you are not sure whether to use ice or heat, always use ice. If the area is inflamed, the ice will be helpful but heat will actually bring in more inflammation. If you have poor circulation, or are a diabetic or have extremely sensitive skin, consult your chiropractor or medical doctor before applying ice or heat.

Dr. Justin Gilmore is a board certified chiropractor and practices at Gilmore Chiropractic located at 146th and Gray Road. You can reach him at (317) 587-2727 or via his Web site

Pro Massage Therapy Comments:

I agree that ice is the way to go whenever you are not sure which way to go.

Remember pain = inflamation.

And inflamation can only be reduced with cold ice.

Massage therapy is a wonderful compliment to chiropractics. If you are using one without the other you are really selling yourself short.

Chiropractics move the bones while massage therapy relieve the stress on the muscles and ligaments that act as trigger points and that may restrict blood flow.

If you have never tried a massage before you owe it to yourself to at least get our $20.08 special. It is a full 40 minute swedish massage that I promise you will find both relaxing and refreshing.

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