Why Ice Is Your Friend… Icing: How & Why

By · Wednesday, October 27th, 2010

It still amazes me how many patients come into the office after seeing their medical doctors that are still using heat on their new pains.

Does this sound familiar?

You throw your neck/back out and you take some over-the-counter (OTC) NSAIDs like Advil and put a heating pad on your acutely painful area.

Why do you do it?

Well, your doctor told you to… or maybe it was a friend or family member whose doctor told them to do it… or maybe you read it online. Who knows, but let’s set things straight.

First of all the premise is that you got hurt.  Some type of injury or exacerbation occurred. On other words you now have some level of inflammation in the tissue around that injured area.  Inflammation usually will include signs of swelling, heat, redness, and pain.

You see it on TV all the time – someone gets hurt playing around and so they reach for their handy bottle of OTC NSAIDs like Advil.

What are NSAIDs?  NSAIDs saids for Non-Steroidal Anti-Inflammatory Drug.  When some on has a severe inflammatory process a medical doctor may prescribe a Steroid to reduce the inflammation.  (In fact, epidural shots are usually a type of steroid.)

Key words = Anti-Inflammatory

So even though I’m not a big fan of NSAIDs (because I think people over use them and end up creating more bodily damage over the years) I understand the reasoning of a person taking them when a new injury occurs.

The confusion comes into play when a person is instructed to place a heating pad on the injured area.

Lets think about this.  The tissue is inflamed.  Drugs are taken to reduce the inflammation and pain.  A person puts a heating pad on the inflamed area.

Does that make sense? (scratching head)

Putting a heating pad on an inflamed area is like adding fuel to the fire.  The heating pad will cause the blood vessels to open even more and there by flooding the area with more swelling.  This is why a heating pad feels good while on, but the pain comes back with a vengeance when the heating pad comes off.

How much more effective would it be to put an ICE pack on the inflamed area?

Now, the NSAIDs and the ICE are working together.  Logical, yes?

Here’s How to Use Ice…

How to Use an Ice Pack from Troy Don on Vimeo.

How to Use Ice

  1. Type of Ice Pack.  Use a large Ice Pack that will completely cover the affected area. It should be as cold as ice, not just cool. Cool doesn’t cut it.
  2. Placement.  The Ice Pack should be on and surrounding the area of inflammation. For Example: the back is swollen and the nerves are inflamed that are causing the leg symptoms, so ice the back, not the leg.  KEY NOTE: it is important to have a thin clothe between the ice pack and the skin to prevent freezing the skin and to allow the cold to penetrate. A T-Shirt is perfect; a bath towel is too thick.
  3. Duration.  Keep the ice pack on your back for 20 minutes. No more, No less.
  4. Repeating the process.  It is safe and effective to repeat the use of ice once every hour.  In other words, 20 minutes on, then 40 minutes off.  So if you were hurting bad enough, you could ice every hour if needed.

“Why 20 minutes? It feels like its taking forever!”
When you keep ice on for a full 20 minutes, if you are not used to the process it may feel like it is taking “forever”.  You will feel changes in the sensation – burning, cold, and numb.  Yes, the last 10 minutes you’ll probably feel numb.  It is in the last period of the 20 minutes that your blood vessels will start to contract and then dilate, close then open, thereby pumping out the bad stuff and pulling in the good stuff that helps the tissue to heal faster.   This is the key.

So, when you hurt yourself, do yourself a favor and use ice.  If you don’t like cold or ice… get over it and make “Ice Your Friend”.  Make it you mantra while you’re getting through the discomfort of the cold.  “Ice is my friend. Ice is my friend. Ice is my friend.”  J


Troy Don, DC QME


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