From the Guidelines
Applying ice to your skin causes blood vessels to constrict, reducing blood flow to the area and decreasing inflammation, swelling, and pain, as supported by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When using ice therapy, it is essential to follow the recommended guidelines to avoid tissue damage. The guidelines suggest limiting the duration of cold application to 20 to 30 minutes for 3 to 4 times daily 1. Some key points to consider when applying ice to your skin include:
- Using a bag filled with ice and water surrounded by a damp cloth to achieve the greatest tissue cooling 1
- Avoiding direct contact between ice and skin to prevent cold injury 1
- Considering alternative modalities such as refreezable gel packs, although they may not be as effective as an ice and water mixture 1 The cold temperature also slows nerve conduction, which temporarily numbs the area and reduces pain signals to the brain. It is crucial to note that while ice therapy is generally safe, there may be certain conditions, such as Raynaud's disease or cold allergies, where its use should be avoided or approached with caution. In the context of real-life clinical medicine, it is always best to err on the side of caution and consult with a medical professional if there are any concerns or uncertainties about using ice therapy.
From the Research
Effects of Applying Ice to the Skin
- Applying ice to the skin, also known as cryotherapy, can reduce pain and inflammation in the affected area 2, 3.
- The primary benefit of cryotherapy is reduced pain following injury or soreness following exercise, as well as reduced metabolism, inflammation, and tissue damage 2.
- Cryotherapy can be used to manage chronic pain, with both local and non-local applications showing promise in reducing chronic pain associated with various chronic diseases 3.
- The effectiveness of cryotherapy depends on its ability to maintain a reduction in muscle temperature and the timing of treatment with respect to when the injury occurred or the exercise ceased 2.
Physiological Effects of Cryotherapy
- The physiological effects of cold therapy include reductions in pain, blood flow, edema, inflammation, muscle spasm, and metabolic demand 4.
- Cryotherapy can produce significant changes in skin surface temperature, but may not necessarily affect pain tolerance thresholds (PPTs) in healthy individuals 5.
- The use of cryotherapy in surgical procedures, acute pain or injury, and long-term pain or dysfunction has been evaluated, with moderate certainty of evidence for its use in reducing pain and improving range of motion after surgical procedures 6.
Considerations for Cryotherapy Use
- The certainty of evidence for cryotherapy use in acute pain and injury or long-term pain and dysfunction is lower, with more research needed to evaluate timing, temperature, dose, and frequency of treatment 6.
- Cryotherapy may be safely used in musculoskeletal injuries and dysfunctions, with few adverse events reported 3, 6.
- More advanced forms of cryotherapy may accentuate its effects, but further research is needed to support its use in managing chronic pain and promoting recovery from exercise and injury 2, 3.