Heat vs Ice: Which One and When?

When it comes to injuries, there seems to be a lot of confusion about when to use ice rather than heat.  I often see patients after they’ve experienced an acute injury due to sports or a car accident. Many times the pain from the incident isn’t felt for days or sometimes weeks.  And here’s why.

As a response to any tissue damage in the body, pain signals are sent to the brain over afferent nerves.  Afferent nerves carry information TO the brain.  There are 2 kinds of afferent nerves. There are Type A and Type C fibers.  Type A fibers have a larger diameter and are covered with a conductive sheath which allows the messages to get to the brain much faster. These are called myelinated nerve fibers.  Type C fibers are smaller in diameter and have no myelin. Therefore the messages over these nerves travel much slower. Pain chiefly travels on type C fibers in order to reach the brain.  Temperature on the other hand travels primarily on Type A fibers. So why is this all important?

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