Ice Or Heat For Back Pain Relief & Injury?

today we're gonna talk about heat and

ice the difference between the two when

they use them and more importantly when

not to use them I can't tell you how

many times I've had patients come into

my office and asking what they did to

help take care of her treat their pain

and they did the wrong thing only making

it worse once a month I have a new

patient that comes in with an extremely

acute episode of low back pain and ask

him what you do to try to take care of

that and they tell me well I fell asleep

on a heating pad and then they couldn't

even move when they got up the problem

is the heat the heat was used at the

wrong time if you use heat improperly

you can make things a lot worse the same

with ice so it's important that we learn

the distinction between them and how to

use them effectively well we talked

about the use of heat and ice for

therapy and treating pain and conditions

the important factor is really blood

flow and how that relates to heat and

ice when you use ice you reduce blood

flow you constrict blood vessels when

you use heat you increase blood flow you

dilate blood vessels so it's important

to understand the distinction between

these two and when to use them ice is

very important to use in the first stage

of injury so your inflammatory stage of

injury is generally the first 72 hours

so if you have an acute injury your

body's gonna respond with inflammation

it's gonna increase blood flow to the

area and that's gonna increase swelling

which in the end is gonna increase some

pain so if we can apply some ice in an

effective manner at the right times we

can reduce that inflammation which is

thereby going to reduce your pain and

actually increase your healing speed as

well when utilizing ice there's a couple

important rules you want to adhere to so

it's really important to do it for the

right amount of time and at the right

frequency of time so you never want an

ice in area more than 20 minutes if you

do your body will actually have a

negative response it'll actually dilate

your blood vessels instead of constrict

them so it's that first 20 minutes we

get the benefit out and then after that

you take it off for at least 40 minutes

to an hour before you do another round

again this is really important to follow

and if you just sit there and fall

asleep on an ice pack or leave it on

there for an hour you can actually do

the opposite of what you're trying to do

which is decrease inflammation you can

actually increase inflammation which

will again increase your pain in that

first 72 hours of the injury you can use

ice multiple times generally I'll tell

my patients to if it's really an acute

injury to use it five or six times in

that day try to space it out by an hour

or two at a time

and no no more than 20 minutes again

it's really important other rules to

kind of pay attention to or never apply

ice directly to your skin

you always want some sort of thin layer

in between it even a thin cotton shirt

or a thin towel will be good to prevent

frostbite and frost burn it's really

important that you don't just apply it

directly to your skin for that entire

time when applying ice during that 20

minutes there's a range of sensations

you should experience first one is cold

second one is burning you should have a

short period of actually burning

sensation that should be followed by an

aching sensation and then it should

follow itself up by a numbing sensation

that at the end of that 20 minute phase

and that's actually the most important

for reducing your pain and your

inflammation so now that we talked about

ice let's talk about heat when do we use

Heat well we used ice during the first

72 hours the acute phase of that injury

well we're gonna follow that up by

starting didn't use some heat heat is

good for chronic issues so if you have a

long-term issue something that's been

there a long time several months heat is

generally a good idea for that in the

acute phase and then follow that up with

the sub acute phase of any other new

injury you can start to apply heat

depending on the situation after that

day four day five you can start to

introduce heat into the situation you

don't want to apply too much at first

and you only want to do it for shorter

periods of time about thirty minutes so

again you don't want to fall asleep on

that heating pad so depending on the

situation and the the acuteness of the

injury you may need to ice it for more

than three days so three days might not

be enough and then it might be too early

for heat so if you still feel very

inflamed or you have very sharp or cute

pain and especially if you have any

radiating pain that goes down your leg

you do not want to put heat on it it's

too early to do that so some people some

of my patients I'll have them doing

icing for a couple weeks before we start

to even get to that heat phase so this

is really important if you have that

acute radiating or inflamed type of pain

don't put heat on it it's not gonna help

you if anything it's gonna make it worse

so for heat we really want to use that

for more of those long-term issues we're

talking about her again not the sharp

pain but when we kind of venture into

that dull achy sort of pain and we're

looking for tight muscles and we want to

deal with that that's kind of where we

want to get into that heat heat is gonna

help increase the pliability that

muscles increase your flexibility and

therefore make you feel better in the


so you're looking for that dull achy

type of pain with the heat so besides

using ice and heat individually you can

actually use them together this is

called contrast therapy and the way you

should always do contrast therapy is to

start with heat first and finish with

ice this says a lot to do with what we

talked about before about dilating and

constricting of blood vessels so when

you put the heat on your blood vessels

are gonna dilate and that's gonna

increase a little more blood flow and a

little more inflammation well it's

important not to let that build too high

and that's why you put the ice on to

decrease it and what that actually

creates is a pumping effect so you

actually dilate the blood vessel with

the heat and then you constrict it with

the ice and doing that back and forth

over time actually pumps fluid in and

out of the area it actually could be a

very good option for reducing

inflammation at someone generally with

contrast therapy we would have someone

start to do this after the acute phase

or after the strictly ice phase which

would be in that day 4 day 5 range if

they're still experiencing some of that

inflammation we don't want them to

solely put heat on because again the

heat is going to increase inflammation

so that's the time we would use contrast

therapy so just a good safety tip when

you're using heat nights there's a few

people and a few situations where you

should never use either one of them

particularly open wounds you don't want

to place heat or ice directly on an open


people that have circulatory problems or

if they're on blood thinner medications

you should not use ice directly on the

skin it can cause issues other people

that have poor sensation like peripheral

neuropathy and diabetes type patients we

don't like to apply these things because

they can end up with an issue because

they're not really sensing what's going

on in those areas alright guys I hope

you enjoyed the video and I hope you

learned when to and when not to use heat

nights it's really important that we use

these things at the right time and more

importantly like I said before not to

use certain things at certain times

because you could make the situation


alright that's it for today we hope you

enjoyed this video and if you did please

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