Do I put a heatpack on my shoulder, neck, back, knee etc. while I am watching television, or will I be doing more harm than good?
Should it be an icepack?

Most sport people and anyone who has done a first aid course will know the general advice on treating a FRESH injury.

Initially, apply ice. The first aid acronym RICE – Rest, Ice, Compression and Elevation is still the advice given to deal with acute injuries. These are the types of injuries sustained on the sports field, or tripping over in the house or garden. They leave you with sudden pain in tissues that quickly become inflamed and swollen. It’s the injuries that you know have happened when you have that ‘oops –wish I hadn’t done that’ moment. Then after thirty six to forty eight hours, advice is to apply heat to encourage circulation and healing to the area. Opinions vary on the REST part of this approach. Some think it’s better to keep up gentle movement. All straight forward so far, let’s now complicate it. Moving on from acute injury to the ‘nagging’ type of pain.

There have been studies that show that icing should not be considered part of a ‘treatment’ but that it is primarily a pain reliever. It can also be used for the pain of overuse injuries e.g. tennis elbow, carpal tunnel syndrome and shin soreness from compartment syndromes. The key to this type of use is ‘if it feels good, do it’. If a great deal of inflammation is present, cold will feel best and heat will not feel right.
If heat feels good and gives relief – do that.
This may seem unscientific and indecisive but there are complicated reasons for this approach. If pain is caused by spasm and trigger points (hyper-irritable minute spasms in muscle) then ice will aggravate the pain. Heat will ease the spasm.

The good news is – if you try ice and it doesn’t relieve the pain, you haven’t lost anything EXCEPT WHEN IT COMES TO BACK PAIN GENERALLY. Best in this case to use heat. You will almost always have more comfort from heat rather than ice.

In summary, trust your intuition. If it feels comforting and relieving to sit watching television with a heatpack on an area, and it feels better afterwards – DO IT. If icing an area (but not your back) brings down the pain level and makes it feel better afterwards – DO IT.

By Barbara Beeck, Remedial Massage Therapist

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