Is infrared sauna preferred over icing for treating acute injuries like high-grade ankle sprains?

From the Guidelines

Infrared sauna is not preferred over icing for treating acute injuries like high-grade ankle sprains, as the current evidence suggests that icing, as part of the RICE protocol, is still a commonly recommended approach, despite its efficacy being questionable 1. The recommended approach for acute injuries, such as high-grade ankle sprains, is still a topic of debate, with the RICE protocol (Rest, Ice, Compression, and Elevation) being a widely recognized method, although its individual components have been subject to numerous investigations with inconclusive results 1. Key points to consider in the treatment of acute ankle sprains include:

• The use of ice, as part of the RICE protocol, has been investigated in numerous studies, with the evidence showing that its efficacy in reducing injury-associated symptoms is unclear 1.
• The combination of cryotherapy (ice) and exercise has been shown to have a greater effect on reducing swelling compared to heat application, and also results in significant improvements in ankle function in the short term 1.
• Other treatment modalities, such as functional support, exercise therapy, and manual mobilisation, have been recommended based on the available evidence, with exercise therapy being advised to start as soon as possible to recover joint functionality 1.
• Heat therapies, including infrared saunas, should be avoided during the acute phase (first 48-72 hours) as they can increase blood flow, inflammation, and swelling, potentially worsening the injury 1. It is essential to note that the evidence regarding the efficacy of different treatment modalities for acute ankle sprains is not always conclusive, and more research is needed to determine the best approach for each individual patient 1. In terms of specific recommendations, the evidence suggests that:
• RICE is not advised as a treatment modality after a lateral ankle sprain (LAS) 1.
• NSAIDs may be used to reduce pain and swelling 1.
• Functional support is preferred over immobilisation, especially the use of a brace 1.
• Exercise therapy should be started as soon as possible to recover joint functionality 1.

From the Research

Infrared Sauna vs Icing for Treating Acute Injuries

• There is no direct evidence comparing infrared sauna to icing for treating acute injuries like high-grade ankle sprains 2, 3, 4, 5, 6.
• The available evidence focuses on the effectiveness of cryotherapy (icing) in treating acute injuries, with some studies suggesting that it can reduce pain and inflammation 2, 4, 5.
• However, other studies have found insufficient evidence to support the use of cryotherapy for acute ankle sprains, highlighting the need for more research 3, 5.
• The use of infrared sauna for treating acute injuries is not mentioned in the available evidence, making it difficult to determine its effectiveness compared to icing.

Cryotherapy (Icing) for Acute Injuries

• Cryotherapy is commonly used to treat acute injuries, with the goal of reducing pain, inflammation, and tissue damage 2, 4.
• Some studies suggest that cryotherapy can be effective in reducing pain and inflammation, but the evidence is not consistent 2, 4, 5.
• The optimal duration and frequency of cryotherapy applications are not well established, with some studies suggesting repeated applications of 10 minutes to be most effective 4.

Treatment of Acute Ankle Sprains

• Ankle sprains are common injuries that can be treated with a variety of methods, including cryotherapy, rest, compression, and elevation 3, 6.
• The evidence for the effectiveness of these treatments is limited, and more research is needed to determine the best approach for treating acute ankle sprains 3, 5, 6.