Ice or Heat?

One of the most frequently asked questions at my office is,"Should I use ice or heat for my pain?" The patient generally goes on to say, "My primary doctor tells me to use which ever feels better, the physical therapist tells me to use heat, and the chiropractor tells me to use ice. I am so confused." I usually reply, "Put ten doctors/chiropractors/ physical therapists in a room and ask a question. You will get eleven different answers."

I will share some scenarios to give you a better idea of which application to use--ice or heat. If you are not sure what to apply, use ice. When an athlete gets injured, you will see him or her immediately receive an ice pack.

For injuries, it is best to use ice, not heat. If you are experiencing a flare-up or aggravation of a condition, use ice. For headaches, I recommend ice. If you have a migraine headache and/or pain over the eyes and pain in the neck (a possible combination of tension headache and migraine), use the sandwich approach. Use one ice pack behind the neck and another ice pack over the eyes.

Stiffness in a muscle or joint responds well to heat. I always recommend moist heat or the heat packs you can microwave as opposed to an electric heating pad. For some reason, most folks achieve better results with the moist heating pad or microwave heating pad.

Let's talk precautions. Never use ice or heat directly on the skin as you could injure and burn the tissue. Always have some kind of buffer (towel, T-shirt, etc.) between you and the ice/heat pack.

Time is also an important consideration when applying ice or heat. In acute cases (a new pain), ice should be used as follows: 15 minutes on, 10 minutes off, 15 minutes on, 10 minutes off and ending with 15 minutes on. In this acute situation, you can repeat this sequence 1 to 3 times a day. If you are icing just once (e.g. after an activity,) apply ice for 20 minutes. You can apply heat for 20 to 30 minutes at a time.

Some of my patients have an aversion to ice. If you are one of those people who react rather than respond to ice, I strongly recommend the following: Put a thin bath towel in the clothes dryer for 20 minutes. Then place the ice pack in the towel and apply to the affected area. Initially you will feel the warmth,then a cooling effect. You can apply this ice/heat for 30 minutes. If your pain does not decrease in three days, I strongly recommend that you see your doctor for an examination.

That's it for now. Stay Well, Stay Healthy!

To Your Health, Wealth & Happiness!

Dr. Michael J. Kaye
Knowledge, Action, Results

My Neck and Back are Stiff Every Morning

Today I am going to discuss how preparing for your day can help minimize pain in the lower back and/or neck. Activities of daily living—the things you do each day such as getting dressed, going to work, doing the laundry—are usually difficult if you suffer with pain. And the morning time before your muscles are used to moving is often the time when pain is at its worst.

Here are some steps you can take to prepare for the day that will help to control your discomfort:

Get your clothes and any other items you need ready for the next day before going to bed. Don’t forget your socks and underwear! You want to do this to avoid rushing around in the morning. When you have to rush, it is easy to move without being careful, increasing the possibility of injuring yourself.

If you suffer with morning stiffness and you carry a laptop or briefcase, put them in your car the night before to avoid bending and/or carrying objects in the early part of your day. Don’t forget to lock the car!

If your mornings are difficult, set your alarm clock to go off 30 minutes earlier. This will give you extra time to warm your muscles in a hot shower. Speaking of showering, it is best to keep all your bath products at waist level where they can be reached easily. If you suffer with neck pain, you want to avoid reaching overhead and if you suffer with lower back pain, you want to avoid bending in the morning.

You will want to use an electric toothbrush to avoid bending at the sink to brush your teeth. Just five degrees in forward bending at the waist places your lower spine in a precarious position and you may experience sharp pain. If you blow dry your hair and suffer with neck, arm and shoulder problems, you may want to consider purchasing a stand to hold the hair dryer (Google hair dryer holder/stand).

Do some stretches to address the problem region.

If you have lower back problems, you should stretch your hamstring muscles. The hamstrings are in the back of your legs, extending from your sit bones to the back of the knees. To stretch the hamstring properly, lay flat on your back with both knees bent and feet flat on the floor. With one knee bent and foot flat on the floor raise the other leg straight in the air (or as straight as you can) and hold behind the knee for 10 seconds. Repeat. Perform two repetitions of the same with the other leg. The next movement requires both legs straight (as opposed to knees bent). Raise and straighten one leg in the air and hold for 10 seconds. Repeat with other leg. Perform two sets, 10 seconds each leg.

If you have neck problems, the best morning exercises are two range-of-motion maneuvers. Drop your chin to your chest and roll your head to one side. Hold for three seconds, then roll to the other side and hold for three seconds. Repeat. Next, tilt your head to one side (ear to shoulder) and hold for three seconds. Tilt your head to the other side and hold for three seconds. Repeat.

The golden rule of exercise: If there is pain, stop the exercise. If you experience increased pain in your back or neck or tingling or numbness in your arms or legs when performing these exercises, stop the movement patterns and let your doctor know of your symptoms.

The simple act of preparation by stretching your muscles can help manage pain in the neck and lower back. And, yes, most definitely, these exercises should be performed every single day!!!!

To Your Health, Wealth & Happiness!

Dr. Michael J. Kaye