Occasionally, patients will come in with back pain or injuries who have been told to put a heating pad on it by their doctor. My philosophy is to give patients information and have them make decisions, so I walk them through the “injury cascade of events”. (This is like your little brothers in the back seat of the car when one calls the other a name, the other retaliates, then one pushes the other, more retaliation, eventually leading to a full blown hockey brawl.)
When muscles, ligaments, or tendons are injured, they release mast cells. These cells secrete histamines (the things that make your sinuses swell). The histamines allow your blood vessels to leak plasma but not blood thus allowing the tissue to swell.
God or mother nature designed the system this way. Swelling makes the area more stable like it has a splint on it and causes pain so we don’t use the structure. Swollen and inflamed tissues which are exposed to more heat tend to swell more.
The logical conclusion is to put ice on the structure to reduce swelling.
After 48 hours, sometimes we we recommend using heat for 20 minutes followed by ice for 10 minutes (always ending with ice). This engorges the tissue with fresh oxygenated blood followed by reducing the saturation of blood. This is a good way to accelerate healing of bruising.
Anti-inflamatory medications reduce inflammation too but repeated use over the long haul can damage your kidneys. Ice has not been found to cause damage unless thrown by your little brothers.