Chapter 12 Icing or no icing

Most people came to my office or our school clinic because they are suffering from pain. IN our society, pain killer and icing seem to dominate the choice of therapy. Icing seems to be the golden rule of thumb for pain management. I had to admit it, I did that too long time ago. When my son jammed his finger playing balls at the age of 6. I had him immerse his swollen thumb in the ice water cup even when he fell asleep with head resting on the dinner table. That was 25 years ago; I was a senior scientist developing medical devices. I knew of nothing about acupuncture. If it were today, just one needle and some moxa, he would be good as new in no time.

Icing has an important place in the pain management- right after trauma. It is beneficial, depending on the severity of the trauma, up to several hours... Beyond that the benefit of icing should be very carefully evaluated. In my experience, it does a lot of bad thing for the patient.

Case in point, a 15 years old son of a patient wanted to know whether I could treat her son’s swollen ankle which had been bothering him for two years. He got sprained ankle in the soccer. After the incident he was treated by a medical doctor and went through a course of physical therapy and discharged. Two years later, he still walked with slightly distorted foot apparently due to pain. His left ankle was swollen laterally over ankle bone.

The mother did not seem to believe me when I told her that with acupuncture; sprained ankle needed only one to two treatments to resolve 80-90 percent of problem. I used Infrared lamp on his problem ankle for 20 minute, followed by a few acupuncture needle insertion. The main acupuncture points were LI10, Lv7 and Lv 8 on the same side of his affected ankle. Frequently, I asked him to flex the ankle.

After the treatment was finished, the swelling was 50 % smaller, the pain was almost 90% reduced.  After a couple more times of treatments, he started dancing with no difficulty.

The key reason for his prolonged ankle pain was icing. His mom was very meticulous in following doctor’s order, religiously icing his ankle, like daily ritual after his physical therapy had ended. I told her not to do it any more at home, instead, to the extent possible, use heat pack on the ankle daily.

This is not an isolated case. On the contrary, the practice of icing is so universally accepted that it became the first thing I discuss with patients with pain issues. I emphasize this practice in the school clinic that my students would automatically educate the clinic patients not using ice- not on the ankle, not on the back, not on the neck, not on the heat. Not on any place on the body.

Why not icing, after-all, isn’t true that doctors routinely prescribe icing to their patient after surgery or after trauma-  the triad ICE ( ice, compress and elevation)  is well established as rule of thumb for tending traumatic injury.

It is absolutely true and necessary in such situations. The purpose is to reduce the blood flow to the affected area preventing it from swelling. Everybody knows that tourniquet has saved many of our soldier’s life by stopping the blood loss. But because the blood flow is stopped, they often lost their limbs by amputation.

Although, not as severe to the body’s health, icing does reduce the blood flow to the affected part of the body and likewise jeopardize body’s ability to heal itself. So, it is very important to stop icing as soon as possible such as a few hours. Beyond which, continuing icing is not helpful and actually hinder the resolution  of swelling. Heat therapy should be started.

One argument for icing is for pain control. Some people have severe pain and doctors can’t heal them. With icing, they feel less pain. This includes headache, back pain. This is understandable but not a good strategy. The best advice I will give is to seek effective doctors. Remember, ice never heals. Body does. Blood circulation does.