S E14: Ep 14 – If you are in pain should you use Cold?
Everyone knows that ice is good for managing pain but most don’t know how it works or when to use it.
There are many protocols for using ice ranging from old skool RICE (rest, ice, compression & elevation) to the latest PEACE & LOVE (Protection, Elevation, Avoid anti-inflammatories, Compression, Education & Load, Optimism, Vascularisation, Exercise).
I will cover the difference in approaches in another podcast but for now let’s look at when you should use ice and when you shouldn’t.
In this episode, I explain when ice can be helpful, its physiological effects, and the trade-offs involved, providing clear, actionable advice if you are dealing with pain or injury.
When to Use Ice
Ice is most beneficial immediately after an acute injury-such as a sprain, fall, or sudden trauma when swelling, redness, and pain are present. Applying it in the first 48–72 hours can help control excessive swelling and help to numb the pain.
How Ice Works:
Ice causes vasoconstriction (narrowing of blood vessels), reducing blood flow, swelling, and inflammation. It also dulls pain by slowing nerve signals.
The Trade-Off:
While ice can reduce pain and swelling, it may also delay the body’s natural healing process by slowing inflammation, which is crucial for tissue repair. Prolonged or excessive icing can lengthen recovery time and, in rare cases, cause tissue damage.
Best Practices:
Use ice for 10–20 minutes at a time, wrapped in a damp towel never apply directly to skin. Allow at least 30 minutes between icing sessions.
Ice is most effective within the first 48–72 hours post-injury
Avoid icing if you have certain conditions (e.g., diabetes) or impaired sensation.
When Not to Use Ice:
For muscle tears or injuries with minimal swelling, ice may not be beneficial and could hinder healing. After the initial 2–3 days, focus shifts to restoring blood flow and promoting natural recovery.
Latest Guidelines:
Recent approaches (e.g., PEACE & LOVE) emphasize protection, education, and gradual loading over prolonged icing.
Ice is a good tool for temporary pain relief and swelling control, but not for accelerating healing.
For detailed protocols and contraindications, see the links in the show notes.
Takeaways
- The application of ice can be beneficial in managing acute injuries, particularly when swelling and inflammation are present.
- While ice can provide temporary relief from pain, it is crucial to understand that it can also slow down the healing process.
- Individuals with conditions such as diabetes should exercise caution when using ice for pain management.
- Understanding the trade-offs of using ice versus heat is essential for effective pain management.
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Transcript
Hello and welcome to the Pain Free Living Podcast with me, your host, Bob Allen.
Speaker A:I've been treating pain since:Speaker A:So what I'm going to talk to you about today, and it's a question that I do get asked quite a lot by clients, is ice.
Speaker A:When do I ice or when do I use heat?
Speaker A:If you look on the Internet, you will find many, many, many differing views on whether you should use ice or not.
Speaker A:So what I'm going to do today is to give you a little bit of a summary of my view on how ice should be used and hopefully it will make some sense to you.
Speaker A:So when should you use ice?
Speaker A:If you have an acute injury?
Speaker A:So if you've had a trip or a fall and you've got a joint that's starting to swell up and get red and inflamed and angry and painful, then ice is your friend.
Speaker A:Having said that, my answer should be, it depends.
Speaker A:Because the way that ice works is that it helps to numb the pain.
Speaker A:So it can affect nerve transmission.
Speaker A:So it kind of dulls down the pain receptors.
Speaker A:It causes what we call vasoconstriction.
Speaker A:So the blood vessels in and around the injured area actually narrow.
Speaker A:So it reduces blood flow to the area, which can then reduce swelling.
Speaker A:That's a good thing, but it can also be not such a great thing.
Speaker A:Now, while you can use ice to control inflammation and reduce pain, the downside of it is because inflammation is a natural process.
Speaker A:When you have an injury to a joint or a muscle, inflammation is part of the process.
Speaker A:Now if you slow down that process, which, like I said, can reduce inflammation, can reduce swelling, you're also reducing the, the, you're also lengthening the amount of time it takes for that injury to heal.
Speaker A:So there's a bit of a trade off there.
Speaker A:When I say to people that ice can be good and beneficial, it can reduce pain, but on a temporary basis only.
Speaker A:So if you have an issue where you can't tolerate anti inflammatories, ice can be a good go to.
Speaker A:But if you overdo using the ice, then you're actually slowing down the healing process.
Speaker A:So that's kind of the trade off.
Speaker A:So ice is good to an extent.
Speaker A:There's, there's various protocols around it which I haven't got time to go into in, in this video.
Speaker A:But knowing that information, you can now go and look up some information around ice because one of the things that they, they don't tell you is that it can actually slow down healing process.
Speaker A:So, so now you know that you can go off and you can look up how, how long to apply it for, how to apply it.
Speaker A:So you don't put ice on bare skin.
Speaker A:You would wrap it in a damp towel and then apply it and you'd apply it for say, 10 minutes at a time.
Speaker A:So there are protocols out there, some quite good ones.
Speaker A:And what I'll, what I'll do is I'll put some information in the show notes about where you can go to get the detail.
Speaker A:But the key thing you need to know is that if you use ice, it can work, but it will slow down the healing process.
Speaker A:Any downsides?
Speaker A:Yes.
Speaker A:So the other thing to be aware of is if you have problems like diabetes, which can cause issues, if you use ice, there, there are, there are other things that you need to be aware of.
Speaker A:So what I'll do is, like I said, I'll put some information, a link in the show notes to some good quality information about using ice.
Speaker A:But I just thought I'd throw out a quick video to let you know that yes, it does work, but it depends on why you're using it.
Speaker A:If you've got an event coming up or something like that, it can slow down the process of healing.
Speaker A:So now you know.
Speaker A:And that's it.
Speaker A:So that's it for another short episode of the Pain Free Living podcast.
Speaker A:Like I said, if you've got some useful information out of this, if you've got any questions, drop them below in the comments.
Speaker A:If you found it useful, tell all your friends like and subscribe to the podcast and I'll see you at the next one.
Speaker A:Nice.