Pain Relief: Heat or Ice?
February 16, 2009 by phil · 2 Comments
Both heat and cold are frequently used in the management of musculo-skeletal pain such as sports injuries or back pain and patients frequently ask me which is best as a first aid measure. In general terms cold or ice are most effective for recent injuries. Given the choice most of us would rather apply a comforting warmth than chilling numbing cold when we hurt ourselves. It seems intuitive to apply heat. Unfortunately in the majority of situations cooling the injury site is far more beneficial, though heat can be useful in a few chronic conditions with an element of muscular aching.
Cooling as therapy, sometimes called Cryotherapy , has a very long history dating back to the Ancient Greeks. Its use for musculo-skeletal injuries became popular in the 1970s. There are several metabolic effects of cooling body tissues which may contribute to pain relief and faster recovery. These include local slowing of metabolism that in turn slows the rate of nerve impulses increasing the pain threshold. Also the inflammatory response to tissue damage is inhibited due to reduced local blood flow, resulting in less painful swelling.
The duration of cooling is important because after a certain time lymph drainage starts to be reduced. As inflammation is carried away through lymph vessels this stage is best avoided. Limiting cooling to ten minutes or less avoids this problem. Side effects of cooling are usually limited to mild discomfort however too much cold can lead to frostbite in local areas and hypothermia when applied to the whole body. This is another reason to only use short cooling periods. Care should be taken to protect the skin from direct contact with the cooling medium, for instance by wrapping it in a cloth.
One misconception is that cooling is only effective straight after an injury. Low levels of inflammation with no visible swelling will continue to cause pain. Continuing ice packs or other cooling measures for several days after the onset of pain can lead to more rapid healing and better pain control. The most effective way of applying cooling is to alternate 10 minutes of cold with spells of warming, aimed at returning the injury site to normal temperature before another spell of cooling. This technique is called contrast bathing. This maintains good lymph drainage and prevents damage from over cooling whilst allowing longer duration of anti inflammatory action.
For minor injuries such a localised muscle pull or minor ligament strain a short course ice packs can be enough to resolve the problem. However if symptoms persist it is important to see an appropriate health care professional.
Closed Monday 9 February (Magha Puja)
February 6, 2009 by phil · Comments Off
Magha Puja image http://www.at-bangkok.com/
We are closed on Monday 9 of February for the Buddhist festival of Magha Puja or Sangha day. You can find out more about this important day in the Buddhist calendar at http://www.thailandlife.com
Appointments February 2- 7 2009
February 2, 2009 by phil · Comments Off
Apologies for any inconvenience but this week appointments are only available on Monday 2 , Friday 6 and Saturday 7 February.
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