Acupuncture is great for reducing pain and inflammation. We help many patients arthritis, sports injuries, back pain, sciatica, etc. So my patients are often surprised and skeptical when I advise them to reduce or stop using ice on their injuries. This is usually followed by lots of questions and a little bit of suspicion. After all, this is exactly the opposite of what we’ve all been taught to do for decades when we have an injury, which is RICE: Rest, Ice, Compress Elevate. To this, I respond with one equally surprising fact…Dr. Gabe Mirkin, MD, the author of the book that first championed that advice, is now advising you to no longer ice or cool your injuries in most cases (see http://www.drmirkin.com/fitness/why-ice-delays-recovery.html). This is in line with my training and experience as an acupuncturist because I believe that ice slows down the healing process and inhibits the flow of Qi and blood.
So why shouldn’t you ice your injury?
Inflammation, while not always pleasant, is a healing process. It brings healing substances from your body to the site of injury that aid in repairing and rebuilding and clearing out dead or damaged tissue. When you ice your injury you are constricting the blood vessels, effectively slowing healing and locking all that dead tissue in place. This could lead to chronic problems that could have been avoided if you had let your body do its thing. As Chinese medicine practitioners, this is something we have known for a very long time. One of our main tenets is that when there is free flow of blood and energy, there is no disease. One of the main functions of cold is to slow things down and constrict, which is in direct opposition to what we are trying to accomplish.
When is it okay to use ice?
Another tenet of Chinese medicine is to maintain balance or homeostasis. This is not a fixed state, but adjusts to the circumstances of what is affecting the body. So if your injury is acute and very hot, swollen, and red, then a moderate amount of cold (not as cold as ice so a cold towel compress) would help to balance that, especially in the initial stages of the injury. If you came in to our office, we would probably use herbal medicines that are energetically cold to help clear out the heat or reduce the swelling. Dr. Mirkin now suggests if there is moderate to extreme pain only 10 minutes of cooling, then removing it for 20 minutes, which can be repeated once or twice and only right after an injury.
What should I do instead?
Make an appointment to see your acupuncturist. A few acupuncture treatments can quickly reduce inflammation and promote healing. If there is no significant heat or swelling and you are able to tolerate it, heat can be used the next day and for the next several days. Then your best bet is to let it heal and to rest the affected area.