heat and dit da

[Yael Grauer]

An acupuncturist told me that in Chinese medicine, they never use ice for injuries because it supposedly pushes the injury deeper and can cause arthritis in the area years later. I don't always listen to everything TCM folks say because 1) they say some really weird things and 2) there's no way to definitively prove it was the ice and not the original injury that caused the arthritis. However, I tried her recommendation (dit da jow topically with a hot-as-you-can-stand towel over it) and it felt SO good and brought immediate relief. Anyone else tried anything like this? I thought it was more fun than trying to figure out how something can still hurt when it's iced to numbness.

[Ken Urakawa]

Wouldn't it depend on the type/severity of the injury to some degree?

[Yael Grauer]

I suppose so! I'm talking about strains, sprains, bruising, things like that. I've been asking acupuncturists I know and the most they will admit to is using ice once right after an injury for no more than ten minutes. They also told me that ice is very good for dead people, because it helps them keep.

Research-wise, I've read about the efficacy of hot/cold and cold/cold (and there's a lot of science to back both up), but I haven't found anything about heat alone.

Clinically, it does seem that almost all of these types of injuries can be characterized as "cold" injuries (i.e. cold makes it feel worse, heat makes it feel better) and most acupuncturists I know seem to have a very high success rate in dealing with injuries (mostly long-term recurring pain) as well as other "cold/damp" conditions like arthritis. (This, of course, doesn't mean they are right about ice, only that there seem to be ways to treat cold/damp conditions successfully without the use of ice.) I also know a top-notch Hispanic herbalist and curandero whose school has the motto "blood follows heat" and I'll have to ask him if he ever uses ice. In my own experience, I've used warming herbs topically for a small handful of people (about two dozen) following an injury (usually 2-7 days later) and it works very well and often immediately. This would include liniments with rosemary, mustard powder, ginger power, sometimes cayenne, foot baths with rosemary essential oil and sometimes camphor essential oil, poultices with a combination of mostly warming herbs, and even just topical application of plain ol' ginger root when it was all I had on hand. I've used ice a LOT on myself and others and I've never seen it get things moving the way that warming herbs do. I have seen some pretty amazing things from hot/cold applications (and I know a naturopathic doc who has a lot of positive clinical experience re: this) but the million dollar question is, what are the long-term effects?

I'm actually planning on asking on a couple e-mail lists I'm on and see if there's research I wasn't able to dig up or any other clinical experience that might be useful. People have recommended Tom Bisio's book to me as well.

[Robb Wolf]

Not too sure on this. The physical therapy community had its collective ass handed to it a few years ago when they were going after Chiropractic. PT had claimed for years that DC's had no research to hang their hat on...but most of western physical medicine has been used for ages and had no "proof" that it worked. Well...the DC's started publishing research and took the PT's to task and they fell back on "this is what we have always used..." not scientific and the same things that mainstream medicine uses to dismiss "alternative" therapies. You cannot have it both ways!

All that said I think there are now some good studies on ice vs. heat at various points post acute (injury) but this is tough stuff to study thoroughly. How do you cause identitical soft tissue injuries in 2 groups of people to compare this stuff? Clinical communications become important. From my own experience I throw my hat in with post acute cold and then contrast methods after 48-ish hrs. Make inflamed tissue more inflamed and you are fudged. Just because you make something feel more comfortable for a moment does not mean you are making it heal faster.

[Yael Grauer]

Originally Posted by Robb Wolf

Just because you make something feel more comfortable for a moment does not mean you are making it heal faster.

True that, but wouldn't that go for ice as well as heat? Also, if you are making something heal faster but will have issues with it later on, then maybe it's not the most efficacious treatment... so the question is whether or not ice is what causes problems (arthritis, etc.) in the area later on or not... and I think that would be next to impossible to determine.

[Greg Everett]

"Just because you make something feel more comfortable for a moment does not mean you are making it heal faster."

"True that, but wouldn't that go for ice as well as heat?"

The primary use of ice post-acute is not to make the injury feel better, it's to minimize inflammation.