Should you ice
a muscle injury?

We have been using ice for decades for all sorts of ailments and in all sorts of forms, whether as an ice bath for muscle pain or tension, or as a cold compress to reduce fever due to viral infections. Cold baths are used for blood circulation problems; ice bags for joint pain and muscle inflammation.

But is ice THE solution to treat your muscle pain?

Hot or cold? Ice or no ice?

How many times do we get these questions… Lumbar sprain, hot or cold? Neck pain, hot or cold? Muscle pain, hot or cold? Should you ice a sprain? Is cryotherapy effective for chronic inflammation?

Who hasn’t treated a soccer player by resting his or her ankle with ice, wrapped in an elastic bandage on the sprain? Or who hasn’t held their breath while seeing a football player doing a cold-water immersion?

Why do we use ice to relieve pain?

Ice is effective in reducing pain as it is well-known to have an analgesic effect. For example, when suffering from a lumbar sprain, the muscle ache associated to low back pain can be debilitating, especially in the first few days.

Following the principle of rest, ice, compression and elevation for 20-25 minutes on a sprain helps to relieve the pain. Reducing the pain intensity can contribute to gain mobility and strength during the healing process.

Can ice really relieve your pain?

Ice has long been thought to play a role in relieving inflammation after an injury, but is it really effective in reducing inflammation? Would it be more appropriate to take a hot shower or to alternate heat and cold for inflammation?

To get a clearer picture, we need to understand what happens in the hours following a musculoskeletal injury such as an ankle sprain, a lumbar sprain or a tendinopathy.

An inflammatory process begins after a trauma. This is a normal response of the body to an injury or an infection. It can cause heat, redness, swelling and pain.

This inflammatory response is a complex reaction involving several types of immune cells, clotting proteins and signaling molecules. Inflammation is essential to the healing process of injured tissue. The acute pain felt is an important warning signal that prevents us from aggravating the injury.

While some studies seem to show that inflammatory cells can induce tissue damage that could delay the healing process, other recent studies tend to argue otherwise.
Applying ice packs or taking non-steroidal anti-inflammatory drugs would decrease lymphatic drainage, maintain edema, and thereby slow the tissue healing process. Some mediators of the inflammatory response are essential to help organize the tissue repair process (Bleakely et al. 2012, Tagagi 2011).

Although some scientific studies have shown that inflammation could induce collateral damage, new evidence is building up in favor of some inflammatory cells playing an essential role in injured tissue regeneration.

In conclusion,if you can handle the pain resulting from an injury, you probably don’t need to apply ice or take anti-inflammatory drugs. On the other hand, if the intensity of the pain is high and incapacitating, ice is a good option.

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Sonia has been a physiotherapy technologist since 1997 and primarily works with orthopedic patients at the CMI clinics.

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