Back - Leg - Arm pain
Pain between shoulders


Dr. Edward J. Hartey

600 Pennsylvania Ave.

Matamoras, Pa 18336

Office hours:
 Mon.Tues.Wed.Fri - 9 to 7
Thurs and Sat - 9 to 1

        Certified Chiropractic Sports Physicians 

  Call Us Today: 570.491.BACK








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Heat or Ice


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Heat or Ice

By Edward Hartey, D.C., CCSP.

   In my years of practice, I have found that there are many conflicting theories among experts, and non-experts for that matter, concerning the best possible treatment for acute soft tissue injury. In speaking of acute soft tissue injury, I am referring to common problems, such as back, neck, shoulder, and elbow pain and similar ailments that con flare up at any time. It has been my experience that although these are common complaints, most people are confused as to whether to apply heat or ice to painful soft tissue.

I have had many patients present in my office with back pain that they are attempting to self-treat with heat. In most cases, these patients will find their condition does not get better, but in fact, worsens. It is interesting to me that nearly everyone knows to treat a swollen ankle with ice, but when asked why they chose heat over ice to treat other inflamed areas, some people will say they were actually advised to do so. And almost every person will say that ice treatment is just too old and uncomfortable. My advice is simple; if you want to stay in pain, use heat! I explain to them this simple physiological explanation for the detriment heat can cause to an inflamed muscle in the back, neck, shoulder, elbow, etc.

Inflammation means that the area is swollen, hot, red, painful, and not functioning properly. If heat is applied to this area, it will engorge the area with more blood, increase redness, increase swelling, and possibly cause micro-tears in muscle fibers. In other words, heat will increase the inflammation in the area and thus increase the pain and possibly the injury.

The best self-treatment for acute soft tissue injury is the application of ice. In order to avoid further injury to inflamed area, the main objective is to reduce swelling by pushing metabolites (such as lactic acid, prostaglandins, histamines, etc.) out of the area. this can be accomplished with the application of ice.

When treating acute soft tissue injury, follow this simple pneumonic RICE, which stands for R-rest I-ice , C-compression, E-elevation, of the effected area. Ice should be applied for twenty minutes and then removed for forty minutes. This should be done for the first seventy-two hours (three days). Only then, after the swelling is under control and the acute stage is considered to now be sub-acute, should the patient use heat.

At this point, heat will bring fresh blood to the area Blood carries oxygen, which will in turn enhance the heating of the area and help to heal the soft tissue. In this sub-acute state (when swelling has diminished), gentle stretching and exercise can be introduced to the area. At this stage combination therapy should be used; heat is applied prior to exercise/stretching, immediately followed by ice.

If these simple steps are followed when attempting to treat acute pain or soft tissue injury, anyone can avoid causing more injury to their swollen, painful muscles and thus aid in relieving and healing some of their common, acute aches and pains. If, however, complaints persist, follow up with your health care professional to assist in your quest for relief.

Most importantly, remember, an ounce of prevention is worth a pound of cure. Therefore, take simple precautions. For example, during this snowy winter season, when shoveling, stretch before beginning, bend knees when  using the shovel, but do not bend and rotate at the same time. Perhaps the best solution to avoiding those acute aches and pains this wintry season is to get hose children out there to help with the shoveling. They need something to get them away from those television screens. Get them to pitch in. They need the exercise, and your muscles could use the break!

Finally, remember to see you chiropractor to make of your spine. When the vertebrae of the spine are properly aligned, your structure  is stronger and better balanced, which in turn will allow your muscles to work better, thus allowing you to perform your daily tasks more efficiently and without injury. Stay healthy and enjoy the winter!