How should you self treat an acute muscle or joint injury? Rest, Ice, Compression & Elevation (R.I.C.E) - is the most common advice, but is this best & if it is what does this actually mean you should do.
Rest - this is definitely important especially if it's an injury to the limb. However, the closer the injury is to the spine the more important it will be to move that area in order to ensure that the area does not seize up.
For example an injury to the ankle would require as much rest as possible. However for an injury in the low back say in the muscles in your flank, total rest would be inadvisable and gentle movements & stretching will speed your recovery.
This would also be true for an injury even closer to the spine, for a disc injury, gentle movement which does not cause pain will start to re-establish normal movement in that area & help drain inflammation from that area.
Ice -This can be applied via an ice pack, bag of frozen peas or even a cold can of coke if that is all you have got. Chilling the area will not only help with pain relief but it will also drive blood away from the injured area, this will take down the inflammation in the area which will help with recovery. Also when you take the ice off the area fresh blood will rush back into the area which will accelerate the healing process.
This process of forcing blood away & then back to the injured site is vital for vastly reducing recovery times. So the formula for icing is 10 minutes on & 10 minutes off for as long as your patience will stand. However, don't apply directly to the skin as you will give yourself an ice burn, and don't push the pain levels - when it hurts from the cold take it off - don't give yourself frost bite!
Often people will ask about applying heat to an area - with an acute injury there is a lot of heat there already so no to heat with the following exceptions:
1. If it is an injury to or around the back ice will be less effective than for a limb injury especially if it a back in 'spasm' - instead a hot bath can be effective to loosen you up.
2. People with Multiple Sclerosis (MS) don't do well with cold, this can also be true for people with other long term 'systemic' or rheumatoid conditions.
Compression - This means bind the area with a bandage, this helps protect & rest the injury & also helps prevent too much inflammation which would prevent fresh blood getting into the injured area. It is only effective for an injury to a limb muscle or joint.
Elevation - This means getting the injured area higher than its' normal position- this is again only effective for the limbs, so put your leg up on a chair or your arm on a table with a few pillows under it. Again it helps blood circulation.
Elevation is not relevant for a back injury - for a low back injury often the best position is to lie on your back on the floor, pillow under the head & pillows under the knees in order to keep the knees bent to about 45 degrees. Back injuries are a full topic in themselves so I will write a separate article for this.
The above is all excellent advice tested over 15 years treating patients but unfortunately as a registered osteopath I am bound by rules & regulations & in case you swallow the soap & choke while taking a hot bath after reading this article I have to tell you that this article does not constitute medical advice. Equally if you believe you have more than a simple injury please see a qualified health professional.
Dr. Jonathan Evans (Dr. Evans is a registered osteopath working in the Gold Coast & Tweed Heads area of Australia).