Cold Therapy

Written by PathologyPrevention
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Cold treatment reduces blood flow to an injured area. This slows the rate of inflammation and reduces the risk of swelling and tissue damage.

Cold therapy also numbs sore tissues, acting as a local anesthetic, and slows down the pain messages being transmitted to the brain.

Ice can help treat a swollen and inflamed joint or muscle. It is most effective within 48 hours of an injury. Rest, ice, compression, and elevation (RICE) are part of the standard treatment for sports injuries. Note that ice should not normally be applied directly to the skin.

Types of Cold Therapy

Some ways of using cold therapy include:

  • Cold compress or a chemical cold pack applied to the inflamed area for 20 minutes, every 4 to 6 hours, for 3 days. Cold compresses are available for purchase online.
  • Immersion or soaking in cold, but not freezing, water
  • Massaging the area with an ice cube or an ice pack in a circular motion from two to five times a day, for a maximum of 5 minutes, to avoid an ice burn

In the case of an ice massage, ice can be applied directly to the skin, because it does not stay in one place.

Ice should not be applied directly to the bony portions of the spinal column.

A cold compress can be made by filling a plastic bag with frozen vegetables or ice and wrapping it in a dry cloth.

What is Ice Useful For?

Cold treatment can help in cases of:

  • Osteoarthritis
  • A recent injury
  • Gout
  • Strains
  • Tendinitis, or irritation in the tendons following activity

A cold mask or wrap around the forehead may help reduce the pain of a migraine. For osteoarthritis, patients are advised to use an ice massage or apply a cold pad 10 minutes on and 10 minutes off.

When Not to Use Ice

Cold is not suitable if:

  • There is a risk of cramping, as cold can make this worse
  • The person is already cold or the area is already numb
  • There is an open wound or blistered skin
  • The person has some kind of vascular disease or injury, or sympathetic dysfunction, in which a nerve disorder affects blood flow
  • The person is hypersensitive to cold

Ice should not be used immediately before activity. It should not be applied directly to the skin, as this can freeze and damage body tissues, possibly leading to frostbite.

Professional athletes may use ice massage, cold water immersion, and whole-body cryotherapy chambers to reduce exercise-induced muscle damage (EIMD) that can lead to delayed onset muscle soreness (DOMS). DOMS commonly emerges 24 to 48 hours after exercise.

A study published in The Cochrane Library in 2012 suggested that a cold bath after exercise may help prevent DOMS, compared with resting or doing nothing. The participants spent between 5 and 24 minutes in water between 50 and 59 degrees Fahrenheit, or 10 to 15 degrees Celsius.

However, the researchers were not certain whether there may be negative side effects, or if another strategy might be more helpful.

Cryotherapy is primarily a pain-reliever, but it will not repair tissues.

Ice and Back Pain

Ice is best used on recent injuries, especially where heat is being generated. It may be less helpful for back pain, possibly because the injury is not new, or because the problem tissue, if it is inflamed, lies deep beneath other tissues and far from the cold press.

Back pain is often due to increased muscle tension, which can be aggravated by cold treatments.

For back pain, heat treatment might be a better option. 

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