Opinions on most subjects in health care have been modified, or even reversed, somewhere in the course of their implementation.  Each new discovery may radically shift or overturn common practices associated with how we handle injuries and disease.

The ideas of heat and cold have suffered the same consequences, with advocates strongly opinionated on both sides, or some without any opinion at all.  I once heard a prominent orthopedic surgeon say (tongue in cheek) that he prescribes ice 50% of the time, and heat 50% of the time!

In the 1950s, the usual thought was heat.  Those were the days, too, that doctors did not frequently refer for physical therapy — they didn’t think it was necessary.  Greater understanding , principally through treatment of sports injuries, has caused the medical community to see the need for cold.  Moving from the first two hours after an injury, to four-to-six hours, to 12 hours, to 24 hours, to the current practice of applying cold for the first 72 hours or anytime there is swelling has taken about 50 years to progress.

We agree with and recommend that modern approach.  Many times swelling cannot be seen, but its effects can be noticed with stiffness in a joint or tightness in muscles.  There can be swelling even in chronic injuries or just the heavy usage of a body part, so we typically prescribe cold at the end of the day and after activity.  You see this being done by young baseball pitchers without injury that ice their shoulders after a game as a preserving effect from the damage of inflammation.

Skin and muscles will always prefer heat, for it relaxes and soothes them.  However, when in doubt, start with ice in 20 minute intervals (on/off/on) to see if the pain and spasm reduce.  If you have further questions, feel free to call the office and speak with me directly.  I would be glad to answer questions you have about heat and cold, or any other matter where you think chiropractic might have an answer to your dilemma.

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