Our bodies have an awesome ability to control a stable inner temperature to provide an optimum environment for our organs, muscles and other inner systems to perform under the best conditions. This is called homeostasis. In a human any fluctuation of more than one half degree above or below 37 % causes our bodies to respond in an attempt to return to our optimum temperature. The application of heat or cold will stimulate this response and we can use it to enhance healing and repair in damaged tissues such as ligaments, muscles and tendons, and reduce inflammation in injured joints.

Cold and heat both have the ability to stimulate an increased blood flow to the damaged area through homeostasis. In it’s desire to regulate our body’s internal temperature, the vascular system can speed up or slow down according to the environment. This acceleration of blood flow helps to drain away fluid and toxins released from the damaged tissues and by reducing the swelling, you will relieve the pain caused by the pressure of the fluid within the joint. The question of when to use heat or cold is not so difficult if you abide by some basic rules.

If you have a recent injury such as a sprained ankle, twisted knee or hyper-extended finger then this joint will soon become swollen and hot. It really does not make any sense to add further heat to an already inflamed situation, in fact it will make it worse and so an ice pack would be the correct choice.

Ice packs can be applied in many ways; gel packs are handy but have a short life. I would rather have a good crushed ice pack for hips, shoulders and knees wrapped in damp towels to prevent an ice burn. If you have no access to ice then a pack of frozen peas works very well. Ice is used for conditions such as sprained ligaments, tendonitis, phlebitis, arthritis and many more. The suffix “itis” indicates an inflammatory condition. For peripheral joints such as fingers, hands, feet, toes and elbows, use a washing up bowl or bucket full of water and ice. This may sound primitive but you will get a fast result. Dunk the joint in and out until you see redness in the skin. This is the erythema which indicates an increased blood flow to the area which is what you are after. Usually takes about 10 minutes to achieve a result.

Heat is for muscles. The majority of back and neck pain comes from muscle spasm. Muscle spasms are intensely painful and can quickly spiral into debilitation. Pain causes muscle spasm and muscle spasms cause more pain. Generally I would not choose to use a cold pack on the back as the shock of ice application can enhance a muscle spasm. Imagine how you would respond should someone put an ice cube on your back … the usual reaction is to arch away from the cold which can also incite muscle tension…The occasion when I might consider an ice pack for the spine is when there has been

direct trauma such as a blow to the back/neck and there is bleeding causing a heamatoma or bruise which is when the trauma has caused bleeding into the tissue. In this case a fast application of an ice pack will cause “vaso-constriction” which is when the blood vessels temporarily narrow which will help to slow down any bleeding into the muscles. When bleeding from a blow has subsided (overnight for example) the treatment can then be changed to heat to provide comfort and relax the post trauma muscle tension. The simplest ways to provide instant heat include a hot water bottle, infra red lamp or heating up a damp towel in the micro wave. Please note that any blow to the back or neck should always be checked by a medical professional.