To Ice Or Not To Ice? Acupuncture Insights for Treating Pain

If it hurts, put ice on it, right? In medical circles recently, there has been quite a lot of discussion about when to use ice, or even whether to use it at all. Traditionally, in the West we have used ice after an injury because it keeps down inflammation. But lately there has been an argument that this is the wrong approach. When you injure your body, the argument goes, the injured area is supposed to get inflamed because this is how your body begins to heal. People use acupuncture for pain all the time, and the principles of acupuncture treatment give us some useful guidelines for when to use ice.

Interestingly, in Traditional Chinese Medicine ice is almost never used. Pain is thought to be caused by some form of stagnation or obstruction of the flow of body fluids and qi through the area that hurts, and cold things generally cause our bodies to constrict and contract, thereby exacerbating the obstruction to the free flow.

I thought this article was a pretty cogent  argument for the use of ice in acute injuries:

The bottom line is that a lot of the fears about using ice have not been corroborated by experimental evidence. The use of ice within the first 48 hours after an injury does not seem to slow down the healing process and can be useful to reduce swelling and pain. After the acute phase of an injury though, ice does little besides temporarily numb the painful site.

Here at the Acupuncture Center of Reading, I treat people with painful injuries, both chronic and acute, all the time, and I think the insights of Traditional Chinese Medicine are a little more nuanced when deciding how to treat pain. The effectiveness of acupuncture for pain conditions is very well documented ( I think that ice can be very useful and provide good relief for acute injuries. However I also see older people with chronic low back pain, for example, for whom icing is not helpful.

The principles of Traditional Chinese Medicine tell us that as we age all of us experience a diminishing of the energetic fire that enlivens us and gives us the energy we use to do our daily work, our yang qi. This is a natural and normal process, but it leaves us feeling colder and less energetic as we age. Another common element of the aging process is that we tend to suffer conditions of stagnation and obstruction more easily. So for older people with chronic low back pain, ice will often only make them colder and will increase the stagnation that is a large contributing factor to their pain.  For these people, I find that heat usually offers them far more relief than cold. I often urge people to try both and see for themselves which makes them feel better, because neither approach will injure them further. But I know that in most cases heat will offer greater relief.

Acupuncture is a great therapy for these long term, painful conditions also, because the whole idea of acupuncture is to use the needles like little lightning rods to conduct the qi through the areas where it has stagnated in order to reestablish the free and unimpeded flow of qi and body fluids.  Most of my treatments for chronic pain, especially in older people, involve heat and massage also, the goal being to relax the musculature, get the blood and qi circulating again and allow the body to get its own healing resources to the injured area.