June 16, 2009

Ice or Heat?

I have patients atleast once a day ask the question, should I use ice or heat? With any sprain, strain or bruise there is inflammation, and sometimes bleeding into the underlying tissues. This may cause swelling, pain and delay healing. Ice treatment is generally used in the first 48 to 72 hours of a soft tissue injury. So remember ice the first 2-3 days after any injury. During the initial phase of an injury, the aim is to limit the body's response to injury. Ice will:

• Reduce bleeding into the tissues.
• Reduce inflammation and swelling.
• Reduce muscle spasm and pain.
• Reduce pain by numbing the area.

These effects all help to prevent the area from becoming stiff by reducing excess tissue fluid that gathers as a result of injury and inflammation. Ice packs can be made from ice cubes in a Ziploc bag or wet towel. A packet of frozen peas is also ideal. These mould nicely and can go in and out of the freezer. Ice packs can also be bought in many retail stores, and is a good idea to keep one frozen at all times since most injuries are not anticapated. Take special care when using ice and cold packs. These are very cold and can cause ice burns quickly if used without care and proper protection.

How are ice packs used? Place the ice pack over and around the injured area Do not place the ice pack directly on the skin. Be sure there is a layer of clothing (protection) between the ice pack and your skin. Icing should follow the acronym CBAN - Cool, Burn, Ache, Numb. You should ice until you feel all four sensations of CBAN (this takes about 15 minutes). You run the risk of damaging the skin if ice is left on the skin for any period of time longer then 15-20 minutes. The effect of the ice pack is thought to be improved if it is pressed gently onto the injured area.

How long should ice be applied? Ideally, ice should be applied within minutes of injury for 15 minutes every hour or two. After the first 48 hours when the inflammation should be subsiding and the aim of treatment changes from restricting bleeding and swelling to getting the tissues re-mobilised with exercise and stretching. Ice helps with pain relief and relaxation of muscle tissue.

Heat

Do not use heat on a new injury (for example soaking in a hot bath, using heat lamps, hot water bottles, deep heat creams, etc). These will increase inflammation and make the problem worse. When an injury is older than 48 - 72 hours, heat can be applied in the form of heat pads, deep heat cream, moist heat or heat lamps. Heat causes the blood vessels to dilate (open wide) which brings more blood into the area. It also has a direct soothing effect and helps to relieve pain and spasm. If heat is applied to the skin it should not be hot, gentle warmth will suffice. If heat is applied there is the risk of burns and scalds. The skin must be checked at regular intervals. Ice often gives better and longer lasting effect on the circulation than heat. The pain killing properties of ice are also deeper and longer lasting than heat.

Precautions when using heat and ice - Do not use cold packs or heat: over areas of skin that are in poor condition. over areas of skin with poor sensation to heat or cold. over areas of the body with known poor circulation. if you have diabetes. in the presence of infection.

So remember, ice the first 2-3 days after an injury. Then switch to heat.

May 19, 2009

An exciting new Consumer Reports survey of its readers found that "hands-on" therapies, led by chiropractic care, were the top-rated treatments for people suffering from back pain! This is no surprise to us in the chiropractic profession who have seen first hand the success we have with our patients.

The massive survey also found that chiropractors were given the highest "satisfaction with care" ratings, well above those given to medical doctors who administered various forms of care to back pain sufferers.

The survey, which included 14,000 Consumer Reports subscribers and was reported in the publication's May 2009 issue, found that more than half of the respondents had "pain (that) severely limited their daily routine for a week or longer, and 88 percent said it recurred throughout the year." The report stated that while many go to a primary care physician first for diagnosis and treatment, the majority were disappointed with the results. On the other hand, 59 percent reported that they were "highly satisfied" with the care they received from chiropractors. Following chiropractors were physical therapists (55 percent) and acupuncturists (53 percent), followed by "specialized" physicians (44 percent) and primary care physicians (34 percent).

I know most people who have had chiropractic care will agree with this survey. I am hoping it will change the mind set of those who have not tried chiropractic care, and have been suffering with a chronic, recurring pain that limits their daily routine. I will be glad to accept any new patient willing to try chiropractic, even if you are hesitant to change.