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Ice versus Heat - I am confused.

Posted by Tom on 5/02/02 at 18:12 (082179)

Can't doctors and therapists agree on which is best? You would link that in the 21st century there would be some sort of consensus. WHAT AM I SUPPOSED TO USE AND WHY?

Re: Ice versus Heat - I am confused.

BB on 5/02/02 at 18:16 (082180)

I don't know either. I am also amazed at the lack of agreement on what would appear to be a relatively simple medical question. I recently had ESWT and I am at a complete loss as far as what I am supposed to do.

Re: Ice versus Heat - I am confused.

DR Zuckerman on 5/02/02 at 18:38 (082187)

Hi
Here is what I do and why
Ice for severe pain after ESWT . If no severe pain then heat. Why. you want to increase blood flow to the ESWT area of treatment, heat will do this. Heat is also a mild analgesic. Ice will reduce swelling and numb the area. So if no severe pain get blood to the area which heat will do . Heat also relaxes the surrounding tendons .

Re: Ice versus Heat - I am confused.

Ed Davis, DPM on 5/02/02 at 20:47 (082213)

Tom:

I don't know many doctors or therapists who disagree on this issue. There probably has been concensus on this since the 19th century. You need to provide more information than just 'what am I supposed to do..?'

Ice is used for acute injuries, to reduce pain and swelling. Injuries may be considered acute for the first 48 to 72 hours, occasionally longer. ESWT or even therapeutic ultrasound inflicts a minor 'injury' to tissues so ice can be used after such treatments.

Heat is used once the acute phase of an injury has subsided. Heat can stimulate blood flow and healing to an area. Remember that cold contracts and heat expands so one generally wants to avoid placing heat over a swollen area.

There are circumstances when swelling can persist beyond the acute phase of an injury. Such circumstances may benefit from the use of both heat and cold. Generally, one should start with heat to stimulate blood flow and end with cold. A popular modality known as 'contrast baths' involves alternating hot and cold but generally ending with cold.
Ed

Re: Ice versus Heat - I am confused.

AndrewS on 5/02/02 at 22:13 (082232)

I am 5 1/2 weeks post ESWT. I do hot parrifin wax a few times a day. I dip my heel into the wax for about 5-10 seconds. Then, remove and allow to air dry for about 5 seconds, then back in then back out. I repeat this about 5 times so a thick wax shell is created then I sit for about 15 mins. I repeat this 3-5 times a few times a day. After the treatment, I try and Ice. Will take a dry ice pack, cover it with a plastic bag and rub my heel directly on the bag as much as I can tolorate the cold.

This has recently proved helpful and although far from totally healed, I have noticed moderate improvment verses pre ESWT.

DOn't know if I am doing the right thing, but seems to be working for me.
Andrew

Re: Ice versus Heat - I am confused.

DR Zuckerman on 5/02/02 at 22:31 (082237)

It is a contrast treatment heat then ice . Really can help. Lets see how this continues.

Re: Ice versus Heat - I am confused.

BB on 5/02/02 at 18:16 (082180)

I don't know either. I am also amazed at the lack of agreement on what would appear to be a relatively simple medical question. I recently had ESWT and I am at a complete loss as far as what I am supposed to do.

Re: Ice versus Heat - I am confused.

DR Zuckerman on 5/02/02 at 18:38 (082187)

Hi
Here is what I do and why
Ice for severe pain after ESWT . If no severe pain then heat. Why. you want to increase blood flow to the ESWT area of treatment, heat will do this. Heat is also a mild analgesic. Ice will reduce swelling and numb the area. So if no severe pain get blood to the area which heat will do . Heat also relaxes the surrounding tendons .

Re: Ice versus Heat - I am confused.

Ed Davis, DPM on 5/02/02 at 20:47 (082213)

Tom:

I don't know many doctors or therapists who disagree on this issue. There probably has been concensus on this since the 19th century. You need to provide more information than just 'what am I supposed to do..?'

Ice is used for acute injuries, to reduce pain and swelling. Injuries may be considered acute for the first 48 to 72 hours, occasionally longer. ESWT or even therapeutic ultrasound inflicts a minor 'injury' to tissues so ice can be used after such treatments.

Heat is used once the acute phase of an injury has subsided. Heat can stimulate blood flow and healing to an area. Remember that cold contracts and heat expands so one generally wants to avoid placing heat over a swollen area.

There are circumstances when swelling can persist beyond the acute phase of an injury. Such circumstances may benefit from the use of both heat and cold. Generally, one should start with heat to stimulate blood flow and end with cold. A popular modality known as 'contrast baths' involves alternating hot and cold but generally ending with cold.
Ed

Re: Ice versus Heat - I am confused.

AndrewS on 5/02/02 at 22:13 (082232)

I am 5 1/2 weeks post ESWT. I do hot parrifin wax a few times a day. I dip my heel into the wax for about 5-10 seconds. Then, remove and allow to air dry for about 5 seconds, then back in then back out. I repeat this about 5 times so a thick wax shell is created then I sit for about 15 mins. I repeat this 3-5 times a few times a day. After the treatment, I try and Ice. Will take a dry ice pack, cover it with a plastic bag and rub my heel directly on the bag as much as I can tolorate the cold.

This has recently proved helpful and although far from totally healed, I have noticed moderate improvment verses pre ESWT.

DOn't know if I am doing the right thing, but seems to be working for me.
Andrew

Re: Ice versus Heat - I am confused.

DR Zuckerman on 5/02/02 at 22:31 (082237)

It is a contrast treatment heat then ice . Really can help. Lets see how this continues.