Ice Treatment

Using ice treatment appropriately can help to reduce knee swelling and pain, and can speed up healing.  Ice can be useful after injuries, with longer term problems, especially during flare-ups and after knee surgery.

Here we will look at how ice treatment works, the different ways you can use ice eg ice wraps, and how to use it safely and effectively.

How Does Ice Work?

When there is swelling in a joint, the fluid takes up lots of space. There are chemicals in the fluid that aggravate the nerves causing pain. Also the pressure from the swelling (there is limited space in each joint) causes pain and limits the amount of movement that the joint can perform, eg how much you can bend and straighten the knee.

Ice has an analgesic effect which reduces pain, and helps to reduce swelling.  It works by reducing the amount of bleeding into the joint and soft tissues and reducing muscle spasm.

How to Use Ice Effectively

Ice works most effectively immediately after an injury or surgery (in the first 3-4 days), but can also help reduce pain and inflammation in longer term knee problems. The simplest thing to do is to wrap some ice in a damp cloth eg tea towel. Place a dry cloth on the affected area and then apply the ice for 10-15 minutes.

Do not leave it on any longer as it can cause an ice burn. It can also slow blood flow so much that the good nutrients needed for healing can’t get in and the bad chemicals produced from the injury can’t get taken away. Also, if the body gets too cold it responds by causing the blood vessels to dilate (open more) allowing more blood to rush into the area which actually increases swelling. This is known as the Hunting effect.

Remove for at least 2 hours before reapplying to allow the area to return to its normal temperature. Use frequently to maximise effectiveness.

Different Ways To Apply Ice

1) Ice packs/wraps: you can buy specially designed ice packs/wraps.  They tend to work best as they stay colder for longer and mold well to your shape.  They come in a range of shapes and sizes.

2) Frozen vegetables: peas often work best as they mold best to your shape. Just don’t eat them!

3) Ice cubes/crushed ice: place in a sealed plastic bag and add some water to help it conform to your shape

4) Instant Ice Packs: These are great if you are out and about and/or don't have access to a freezer.  Simply squeeze the pack to activate and you will have an instantly cold pack to use.

5) Frozen ice cups: fill paper cups with water (filled to the top) and freeze. Place the ice directly on to the skin and keep it moving to prevent an ice burn by drawing circles/patterns on the affected area. As the ice melts, fold back the sides of the cup to continue to expose the ice.

6) Cryo Cuffs: These are frequently used after surgery or by athletes.  The cryo cuff system keeps the ice pack cold for long periods.

To find out more about the different ways to apply ice, visit the ice wraps section.

Safety Advice

1) DO NOT use ice if there is decreased sensation – you can’t feel something touching the knee. Check before applying ice as this can be a sign of nerve damage
2) DO NOT use ice if you have high blood pressure – ice constricts (narrows) the blood vessels which increases the pressure in them
3) DO NOT apply an ice pack straight to your skin – place a thin cloth (eg tea towel) between the skin and the ice pack to prevent an ice burn

What Else Can Help?

Ice treatment is a key part of PRICE treatment (Protect Rest Ice Compression Elevation). To find out more about the best ways to apply ice, visit the ice wraps section.  Alternatively, visit the knee treatment section to find out about other treatment options.

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Updated 30th April 2013
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