Cold can help decrease pain, decrease swelling, and help reduce muscle spasms. Arthritic joints feel better and are able to function better when there is less swelling and pain.
Cold decreases swelling through vasoconstriction (or shrinking) of the blood vessels. When the blood vessels are constricted, this decreases blood flow and blocks the release of histamine; blocking histamine decreases the feeling of pain.
Cold also stimulates sensory receptors that help to block the transmission of pain impulses that travel along the nerves. This temporarily increases a person’s pain threshold in the affected area.
When Cold Therapy is Effective
Patients who are unsure of whether to use cold or not should ask their doctor or physiotherapist. Cold therapy can offer benefits in the following scenarios:
- For 24 – 78 hours following injury or orthopedic surgery
- To decrease swelling in arthritic joints
- To decrease pain in arthritic joints
- To decrease muscle spasm
When to be Careful with Cold Therapy
Cold therapy should be used with caution or possibly avoided in the following scenarios:
- Compromised circulation or sensation
- Raynaud’s Phenomenon is present
(blanching or discolouration of fingers when exposed to cold)
- Allergy to cold
- History of frostbite
If one or more of these apply to you, or you are concerned about how to safely apply cold therapy, check with your doctor or physiotherapist.
Its important to keep checking in on the area(s) being treated with cold therapy and stop if there are signs that it is being over-done.
Key Points for Safe and Effective Treatment
Its important to remember a few key points to maximize the benefits of cold therapy and avoid over-doing it:
Continuously monitor for signs of over-cooling: The skin being exposed to cold will redden over the course of a normal treatment. Check it frequently for signs of over-cooling: blanched, white skin. If there are signs of over-cooling, it’s time to stop and give the affected area a rest.
Apply the RICE method to decrease swelling: The RICE Method
(Rest, Ice, Compression, and Elevation) is an effective combination that will help further decrease swelling.
Rest between treatments: Rest at least 2 hours between cold therapy treatments
Take care with ice and cold packs: Don’t fall asleep with an ice pack on!
How to Apply Cold Therapy
There are a number of methods and techniques that can be used to apply cold therapy treatments at home:
Cold packs can be sealed gel freezer packs from the store, bags of frozen vegetables, or crushed ice in a bag.
- Place a moist towel between the pack and the skin to improve conduction of cold.
- Apply for 10 – 15 minutes
The Ice Massage technique involves freezing water in a paper cup to make handling it easier. This technique works well for small body parts like the elbow.
- Rub the ice over the skin of an affected area in a circular motion. Peel the cup back as the ice melts.
- Apply for 5 – 10 minutes
Cold baths work great for the hands or feet.
- Fill a bowl or wash basin with tap water.
- Add ice cubes to achieve the desired temperature. Water temperature can vary between 13 – 18 degrees Celsius.
- Apply for 5 – 10 minutes
The Ice Towel technique is great for parts of the body where it might be difficult to use a cold pack, such as an ankle.
- Wet a towel
- Place the towel in the freezer so that the water freezes
- Mold the towel to the affected body part
- Apply 10 – 15 minutes
Contrast baths involve alternating the use of cold and warm water.
- Fill one bowl with warm water and one with cold water.
- Start and finish by soaking in the cold water. Soak in cold water for 60 seconds and warm water for 30 seconds.
- Maintain the alternating pattern and apply for a total of 5 – 10 minutes