When should I switch from icing to heating an injury?

When should I switch from icing to heating an injury?


By Melissa Lo L.Ac., M.S.O.M.

Licensed Acupuncturist

Owner of Origin Natural Care


I come across a lot of patients who have injuries that they treat with icing. Patients are surprised when they are told to stop the icing and add in heating. The vast majority of health practitioners will recommend that they ice the traumatized region. It is essential to ice during the first 24 hours of a trauma to stop the flow of blood. In essence we are trying to stop the blood circulation in that region to stop the swelling of the body.

As we all know, MD’s, chiropractors and physical therapists recommend icing throughout the injury to stop swelling. These practitioners recommend RICE (rest, ice, compression, elevation) for injuries because it decreases inflammation and pain and can speed up the healing process. This is why things such as ice baths are commonly recommended for athletes. One of the newer treatments is cryotherapy where a patient will enter a chamber of extreme cold. This dramatic change of temperature can causes a huge release of adrenaline, boosting the immune system, decreasing pain and inflammation.

Where does the idea of traditional eastern practice come of introducing heat? Traditional Chinese Medicine practitioners disagree for the following reason. Ice stops the swelling and continues to stop blood flow. Icing is great for acute traumatic injuries. Once the swelling had reduced, as you continue to ice, you continue to stop the flow of energy “qi” and blood in that region of the body. Long term this can be harmful as it hinders the body’s ability to heal. Therefore for chronic muscular injuries heating is the next recommended step.

Introducing heat after the initial icing therapy allows the body to recirculate the blood and reduce stagnation in that local region. It also helps reduce the discoloration and bruising that tends to occur with constant icing. By increasing blood to the area of injury we are naturally allowing it to heal faster. This is one of the basic ideas as to why acupuncture works so well for injuries. By promoting heating, we are improving blood circulation and flow to the area being treated. The heat also relaxes the muscles and tendons that are tightened, and in essence can increase motion and flexibility.

When it comes to traumatic injuries consider integrating herbal blends to help tissue healing, and recovery. If the area of the body is strained, for example the muscles or tendons are torn or weakened, it is important to make sure additional nutritional support is added. At the same time patients consider immobilizing the body part, without considering rehabilitation. Rehabilitation is just as important as the initial treatment of reducing trauma for long term recovery. I find that adding in dietary recommendations can help patients recover quickly with their acupuncture therapy.