Fire & Ice – (Nothing to do with Game of Thrones)

What’s the first thing that happens when you have sudden onset of back pain and people notice you walking in a careful guarded fashion? Everyone has some ‘pearl of wisdom’ about what you should be doing to help yourself. By nature, we are a nurturing society. We want to help. Sometimes however, the advice given hinders rather than helps us.

Nearly all the people asked would prefer to something hot on a painful region. The consequences can be dire!

Nearly all the people asked would prefer to something hot on a painful region. The consequences can be dire!

Ask one hundred people which would they prefer ‘Heat’ or ‘Ice’ to put on the painful region and nearly all of the people asked would opt for heat. And why not? We automatically associate heat and warmth with relaxation and calm – happy days.

I can now with almost one hundred percent accuracy pick out those new patients that have put heat on the painful region. They are more hunched over, their pain scale is much higher, and their tolerance to simple examination procedures and movement is minimal. So what is happening here? Why should we be putting something cool on a painful region rather than heat?

In a response to tissue damage, the body will release a nasty chemical ‘soup’ in the damaged region. It does this for a number of reasons I will not explain here however, a few of the chemicals released are known to irritate nerve fibres responsible for perception of pain. Applying heat to the damaged region makes muscles relax (that feel good feeling) the down side is that the blood vessels relax after applying heat. This allows more of the nasty chemicals to get to the damaged region. The result? The pain intensifies after about 30 minutes of applying heat simply because you have helped introduce the nasty chemicals to the damaged region.

The solution is simple. Ice is your friend.

Applying a cool pack to the region causes blood vessels to narrow. Your therefore restrict the passage of nasty chemicals to the

Put something cool on a painful area. It acts as a natural anti-inflammatory and painkiller.

Put something cool on a painful area. It acts as a natural anti-inflammatory and painkiller.

damaged region. Less nasty chemicals reduces irritation of the nerve fibres responsible for perception of pain. It even calms them down. The result?  The damaged area becomes less painful. A beneficial side effect is that an area of tissue damage will act as a natural painkiller – reducing pain nerve fibre activation without the use of drugs.

Simples!