Home Pain Relief

1. Treating Injuries In The First 1-3 Days
   Safely Applying Ice
   During the first 24-72 hours after an injury such as a SPRAIN (tear in a ligament) or a STRAIN (tear in a muscle) it is very important to stop the buildup of fluids around the injury. Excessive accumulation of blood and other cellular fluids at  points of injury can lead to prolonged disability and impaired healing strength. With new injuries, in the first 24-72 hours, it is generally advisable to apply ice. At this time in an injury ice is very effective in reducing pain as well as promoting healing.
   
   
   The Physiology of Ice - Cold slows chemical reactions. Slowing the development of inflammation (a chemical and physical process) protects the body and reduces pain. Ice also causes blood vessels to contract, decreasing blood flow and slowing the development of edema (swelling). Edema can impair circulation, decreasing the delivery of nutrients for healing as well as the removal of inflammation from the area. Ice is used in the first 24 - 72 hours after injury or the appearance of acute pain. Acute pain is pain with a sudden onset, either from a known trauma like a fall or idiopathic (no known cause) onset. If you are not sure when a condition began always use ice before trying heat. Applying ice too late in the inflammation process will be of little benefit but is very doubtful to worsen the condition. Applying heat too early however can worsen the inflammation and make your pain temporarily more severe. If you should apply heat or ice and your symptoms worsen, don't panic. Wait 10 minutes and then apply the opposite (heat vs. ice) therapy. Your pain should reduce. Call the doctor when any adverse turn in your condition occurs for any reason. Most often some brief advice over the phone is all that is needed.
   
   
   How to prepare Ice - I feel the "jelly type" ice bags are the easiest and safest to use. Place these in the freezer for at least one hour. Apply to the affected area over one layer of paper toweling for 10 - 15 minutes. Remove and apply again as needed to manage your pain no more often than once an hour. If you choose to use an ice bag containing ice and water of your own mix understand that it is possible to create an ice bag that is too cold and can damage the skin with a "cold burn". Use a layer or two of damp Turkish towels under this type of ice bag.
   
   
   How to apply Ice - For pain radiating from the spine down the arm or leg place the ice bag close to the spine laying lengthwise in the direction the pain travels. For local non - radiating joint pain, such as tennis elbow or a sprained ankle, apply the ice directly to the joint wrapped around it as much as possible. Hold the ice bag in place with an Ace bandage or wrap with a towel.
   
   
   Cautions with Ice - The skin can be burned with extreme cold. Avoid applying the ice directly to the skin without some type of insulating toweling. Do not apply the ice too often, generally only once an hour. Some individuals with certain circulatory abnormalities should avoid the use of ice, consult your doctor first.
   
   
   Treating Injuries After The First 3 Days
   Safely Applying Heat
   72 hours (three days) after an injury the peak of inflammation has usually passed and ice is usually not as helpful as heat. Applying heat now will reduce the stiffness in injured areas as well reduce the pain.
   
   
   Physiology of Heat - Heat accelerates chemical reactions. About 72 hours after injury heating inflamed tissue can help accelerate the healing process. Heat dilates blood vessels, increasing the blood flow in that region. This helps flush inflammation out of the area as well as increasing the delivery of healing nutrients to the injury. When heat is applied to the skin it evaporates moisture in the skin. This evaporation is the body's way of controlling it's temperature and protecting itself from heat injury. When available moisture in the skin is exhausted the body is less able to protect itself and may suffer a burn. "Moist" heat is therefore less drying on the skin allowing for longer and deeper heating with less chance of a skin burn than "dry" types of heating pads. Heat causes the body to try to cool the heated area back to normal body temperature. This flushes blood through the area and helps to remove inflammation. Heat should be used for 5 - 15 minutes, removed, and applied again if needed no more often than once an hour. Using heat too frequently does not allow skin moisture to return to normal levels and may result in a burn. Individuals with dry skin will burn more easily and should use caution with heat.
   
   
   How to prepare heat - Dry heating pads are effective, safe and the least expensive. Follow the above procedures. Moist heating pads are available from pharmacy and surgical supply stores. Thermophores draw moisture from the air. Other types require your moistening a sponge liner. Hydrocollator packs require your heating them in a pot of water to 160 degrees and then either placing them in a special cover or wrapping them in about eight layers of colorfast Turkish towels. The differences in these methods are those of convenience and cost. While we use Hydrocollator packs in the office, I feel that the Thermophore or less expensive wet electric pads are much easier for home use with very acceptable results.
   
   
   How to apply heat - For pain radiating from the spine down the arm or leg apply hot pack close to the spine laying lengthwise in the direction the pain travels. For local non - radiating joint pain, such as tennis elbow or a sprained ankle, apply the heat directly to the joint wrapped around it as much as possible. Hold the hot pack in place with an Ace bandage or wrap with a towel.
   
   
   Cautions with heat - The skin can be burned with extreme heat. Do not apply heat too often, generally only once an hour. Some individuals with certain circulatory abnormalities should avoid the use of heat. Consult your doctor first.

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