Saturday, December 7, 2013

Cold and Hot Packs: Which to use, when and how to make them yourself


Working in first aid at the local ski area, we go through a lot of ice as well as heat packs. The latter are generally used for cold hands and feet, with the ice being used for the aches, bumps, bruises and breaks that can accompany falls.

Below are some basic guidelines to follow. Be sure to talk to your provider about what’s right for you

Ice for Injuries
Most often injuries result from some sort of fall or collision-in short, you know what you did. The area becomes inflamed, with common symptoms including pain, tenderness, swelling and/or redness. Ice is the best immediate treatment because it will reduce swelling and pain. Never put ice or cold packs directly on skin because it can cause frostbite. Put a washcloth or towel between your cold pack and your skin. Use in 10-15 minute increments. Wait about 45-60 minutes before reapplying the cold pack. The skin should return to its normal appearance before reapplying. For hands and feet, it can be easier to soak in a bucket or bowl of icy water.

Acute injuries are iced for up to three days.  After 48 hours, the effect of icing is significantly reduced. Ice as needed, as long as the injured area returns to normal appearance.

Ice can be useful for flare-ups for chronic conditions, such as icing a long- standing injury after playing tennis.

An ice massage can be very helpful. Apply ice directly to the injured area but move it frequently, not allowing it to sit in one spot.

If you sustain an injury, follow the Mayo Clinic’s PRICE protocol
1. Protect the injured limb from further injury by not using the joint. You can do this using anything from splints to crutches.

2. Rest the injured limb. But don't avoid all activity. Even with an ankle sprain, you can usually still exercise other muscles to minimize deconditioning. For example, you can use an exercise bicycle with arm exercise handles, working both your arms and the uninjured leg while resting the injured ankle on another part of the bike. That way you still get three-limb exercise to keep up your cardiovascular conditioning.

3. Ice the area. Use a cold pack, a slush bath or a compression sleeve filled with cold water to help limit swelling after an injury. Try to ice the area as soon as possible after the injury and continue to ice it for 10 to 15 minutes four times a day for 48 hours. If you use ice, be careful not to use it too long, as this could cause tissue damage.

4. Compress the area with an elastic wrap or bandage. Compressive wraps or sleeves made from elastic or neoprene are best.

5. Elevate the injured limb above your heart whenever possible to help prevent or limit swelling.

After two days, gently begin using the injured area. You should feel a gradual, progressive improvement. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin, others) and acetaminophen (Tylenol, others), may be helpful to manage pain during the healing process. If no improvement after several days, contact your medical provider.

Heat for muscle pain (knots, spasms, trigger points)
Note that if you injury a muscle start with cold for the first few days until the inflammation is under control and then switch to heat. Apply heat in increments of 15-20 minutes and be sure to put a protective layer to avoid the possibility of a burn.

Sore, stiff, nagging muscles or joint pain responds to heat. Moist heat is the most effective form. Using Heat for Pain Problems 

Make your own ice and heat packs
With the holidays rapidly approaching, it is easy to make hot/cold packs as gifts. These are generally nothing more than two pieces of fabric sewn together and filled with rice or another grain. Placed in the microwave for a minute or less, they can provide ample heat. To ice, store in the freezer. Links to check out:


Other Resources
The Great Ice vs.Heat Confusion Debacle: A quick guide that explains when to ice, when to heat, when not to, and why.

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