heat versus ice

[Lozen]

My acupuncturist told me that in TCM ice is never used. Her teacher says it is only good for dead people because it helps them keep. But all the research I've read is very pro-ice for strains and sprains and says heat creates more inflammation and is damaging. Any thoughts on this?

[karen]

Great question. Ice/cold is commonly used because the general thinking is to provide the opposite effect of the injury. In other words, if there is inflammation (heat), the idea is to apply cold to counteract the effect. It makes sense only in certain situations.

 

The key is to understand that what you're doing by using heat or cold is applying the law of opposites or the law of similars, depending on the situation. So you have to know in what realm each one applies. The usual reductionist medical mindset is to see every problem as something to be counteracted (law of opposites), but many situations actually call for the law of similars.

 

The law of similars would mean that you apply some heat where there's a problem of excess heat. The heat you apply is similar, not the same, otherwise it's just like banging your head against the wall twice . But it's similar enough that it invokes the law of similars and hastens the cure. You generally use fairly mild heat.

 

Then the question is, how do you know which law to use. When you have a simple imbalance, like getting chilled, it makes sense to use heat to warm up. Law of opposites.

 

But most injuries aren't simple imbalances. There's a real qualitative difference. If you got a little too much sun, you could use the law of opposites and cool off. But if you went so far as to burn, now you have something qualitatively different. It's not on the same continuum anymore. Now you use the law of similars and actually apply a little heat.

 

I know it sounds counterintuitive, but try it sometime if you burn yourself - applying cold feels better initially, but slows the healing process. There's a counter-effect or rebound effect, which could also be explained by the idea that extreme yin turns to yang, and vice-versa. So you usually want to avoid the extremes, and ice is pretty extreme.

 

Applying mild heat to an inflamed or burned area can hurt at first, and it might be a challenge to resist the thing that would numb the pain fast! But with heat, the healing will be much faster. People recover from serious burns without scarring this way.

 

-Karen

[Treena]

I've come full circle on the ice issue. I used to be an icer. Then I realized there are better ways to go about it in the cases of joint or muscle swelling. Getting some energy through the area greatly reduces swelling and doesn't decrease circulation. This effect can be quite immediate.

[Lozen]

Oh that's interesting... but in TCM you do use cooling herbs when it is initially a hot injury, and then switch to hot herbs once it becomes a cold injury, so it's sort of about using opposites to bring about balance, though in a less extreme way, or something.

 

I went through the research and found some that showed hot/cold is good (more heat than cold), lukewarm/cold is better than hot/cold if the injury is particularly inflamed. The amount of heat versus cold varies, but there is almost always more heat used than cold. So I was thinking if the injury is particularly cold (as in, cold to the touch, as my joints often get when I have an injury) then hot/lukewarm might be indicated (the "cooling" part would be the air, or removing heat). I guess this would vary based on the individual. Like, maybe if someone is cold all the time even though they live in the desert, you could use hot followed by lukewarm or something.

 

The theory behind alternating hot and cold is to use heat (or moist heat) to increase the vascular size and transport cellular waste and remove damaged cells, but then use the cold to stop the swelling.

 

There are of course no follow-up studies on the use of ice. I found a study that showed that continuous low-level heat wrap therapy is effective for treating wrist pain and one for heat during back pain (heat and exercise are better than either of the two alone, but either one alone is better than nothing.) Of course this study was funded by Procter & Gamble, who make more money off of their ThermaCare Heat Wrap than they would off of ice packs.

 

The wrist pain article covered carpal tunnel, tendinosis, osteoarthritis, strains and sprains. Heat helps with pain relief and grip strength. It scores the same as placebo for joint stiffness and "patient rated wrist evaluation", whatever that is.

[karen]

Oh that's interesting... but in TCM you do use cooling herbs when it is initially a hot injury, and then switch to hot herbs once it becomes a cold injury, so it's sort of about using opposites to bring about balance, though in a less extreme way, or something.

 

Right. That's because TCM is all about balance and doesn't recognize that some things aren't only about balance. But this comes from the Dynamic school of thought, based on an understanding of the dual nature of the life force, which was only discovered in the 19th century.

 

When TCM was developed, most problems that people encountered were imbalances. But we now have energetic impingements which are qualitatively different from imbalances, so we don't get the best results when we apply the ancient healing techniques in exactly the same way.

 

I went through the research and found some that showed hot/cold is good (more heat than cold), lukewarm/cold is better than hot/cold if the injury is particularly inflamed. The amount of heat versus cold varies, but there is almost always more heat used than cold. So I was thinking if the injury is particularly cold (as in, cold to the touch, as my joints often get when I have an injury) then hot/lukewarm might be indicated (the "cooling" part would be the air, or removing heat). I guess this would vary based on the individual. Like, maybe if someone is cold all the time even though they live in the desert, you could use hot followed by lukewarm or something.

 

It would depend on what the problem fundamentally is. If it's a matter of lack of vital heat, that's not something that can be simply balanced by using warming things. And it's also not necessarily a thermal problem essentially, although there's a thermal component.

 

The theory behind alternating hot and cold is to use heat (or moist heat) to increase the vascular size and transport cellular waste and remove damaged cells, but then use the cold to stop the swelling.

 

It's a mechanical approach, and can be fine for minor stuff, but beyond that it doesn't work well. Even when you get temporary relief, you could be suppressing a problem that will just crop up again later. But we live in a world of specialists, so when the problem crops up in a different form, we go to a different specialist who treats it as something new, when it was really the effect of mismanagement of the original issue.

 

You don't really want to oppose swelling by trying to constrict the tissue, because it's there for a reason. You want to remove the reason why it has to do what it's doing.

 

You might think that with an injury, the reason was the injury itself and you can't undo that. But the injury left an energetic impingement on the life force, and that can be removed. Then the wisdom of the body (with the appropriate support) will heal itself. That might involve some discomfort, but the results are usually better in the long run than if you suppressed the pain by the "ends justify the means" approach.

 

Of course this study was funded by Procter & Gamble, who make more money off of their ThermaCare Heat Wrap than they would off of ice packs. rolleyes.gif

 

Hey, I love those moist heat packs! I think mostly humans have more of an affinity for heat than cold. Especially humans living in NY, hehe!

 

The research you're talking about.. they don't know what they're really studying. You dont' get much useful information studying "pain" because pain is only a symptom, an effect of something, not a cause. So you can study what makes the symptom go away, but you don't know if you've cured the cause or just suppressed it so it will reappear later in another form. This is the problem with the symptomatic approach, which is used in naturopathic medicine as well as allopathic medicine.

 

Even if someone is having accidents, there can be emotional causes that make them prone. Or even things we think are strictly mechanical, like carpal tunnel, aren't purely mechanical. I have small hands, trained intensely as a classical pianist for about 20 years, and now I type all the time and play a big acoustic guitar, and still have never had carpal tunnel problems. But someone doing half that much might develop it. The reasons go deeper, and an accurate diagnosis has to take the whole context into account.

 

That's another reason why "studies" are flawed - each case is really a whole living context. Two people can present with the exact same symptoms, and even have the same TCM patterns, but need two different remedies.

 

-Karen

Edited October 23, 2006 by karen

[Lozen]

Hmmm, I'm not quite ready to dismiss the TCM school of balance thing yet.

 

The research I think isn't entirely useless, just close to it. It's nice to know what will get something to heal quicker...

[karen]

Hmmm, I'm not quite ready to dismiss the TCM school of balance thing yet.

 

The intellect likes to have things just one way or the other - but it's not about dismissing TCM, only using it where it applies and not where it doesn't . Like using tools - you can't say that a hammer is better than a saw - it depends on your understanding of what needs to be done.

 

-Karen

Edited October 23, 2006 by karen

[Lozen]

LOL. Well, I was just trying to find research to back up my desire to use heat instead of ice because it feels better. Now I have to think about the nature of things. It's too much for my little mind to handle!

[Lozen]

Well, this whole deal has been really challenging for me in testing my faith in science versus TCM. i.e. is ice this bad thing that is going to push an injury deeper, or is heat this bad thing that is going to promote extended inflammation and increase the amount of scar tissue and decrease the quality of fiber direction and strength/integrity... lol. Oh yeah, and what was the quality of the original and subsequent injuries or energy imprints and how do I address those.

[Christoph]

Well, this whole deal has been really challenging for me in testing my faith in science versus TCM. i.e. is ice this bad thing that is going to push an injury deeper, or is heat this bad thing that is going to promote extended inflammation and increase the amount of scar tissue and decrease the quality of fiber direction and strength/integrity... lol. Oh yeah, and what was the quality of the original and subsequent injuries or energy imprints and how do I address those.

 

 

Just from my own experience,15 years,ice is by far the best for injury chronic or acute. Heat, for me atleast ,only increases inflamation and does not speed recovery in the least.

[Lozen]

Not talking about speeding recovery--tell me if you have problems in the area when it's cold out years later.

[三江源]

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Edited April 23, 2015 by 三江源

[Christoph]

"Not talking about speeding recovery--tell me if you have problems in the area when it's cold out years later."

 

Not exactly sure what you are saying here. I am refering to application of cold packs on acute and chronic inflamation,usually in the joints.

 

I had patella realignment surgery 15 yrs ago and cold weather doesnt bother it at all and I assure you it has seen plenty of ice packs.

I have had chronic tendonitis of the elbow ,dislocated shoulder, back strains ect.cold weather has no effect and cold packs have always helped and the times I tried heat it did not help and even made it worse for my back spasm.IME

[Lozen]

Interesting. Thanks.

[karen]

Hi Christoph,

 

There are many possible reasons why inflammation might not respond to heat alone - depending on the cause of the inflammation, which is often not just a thermal issue. And cold can palliate pain, for sure. But there's a more important question, I think, of what's the root cause of the pain. And there are many differentials - for example, homeopathic Ruta and/or Rhus are good for tendonitis, and pain from surgery could take a number of different remedies.

 

Yael, good question, to ask what was the real nature of the original injury in order to know how best to treat it, and not just trying to get the pain to go away.

 

Cat, I haven't had personal experience with laser acupuncture, but I'm sure it's a useful tool - but that always depends on how it's used. It's not a matter of which tool is better than others, but is the problem being accurately diagnosed (not fake allopathic disease labels) and is the tool the right one for that particular purpose. Usually practitioners have their favorite tools that theywant to use on everyone, because they invested a lot in training or they got a new cool tool .

 

-Karen

[Lozen]

OMG, rhus tox is the homeopathic that almost killed me.

 

What would you use for an overuse injury?

[mYTHmAKER]

I once went to a physical thherapist who alternated heat with ice.

The idea was to get circulation onto the area

[karen]

OMG, rhus tox is the homeopathic that almost killed me.

 

What happened? It's pretty near impossible for a homeopathic to do harm unless you really try hard to give the wrong remedy and wrong potency repeatedly.

 

What would you use for an overuse injury?

 

Combo of Arnica/Rhus/Ruta.

[Lozen]

What happened? It's pretty near impossible for a homeopathic to do harm unless you really try hard to give the wrong remedy and wrong potency repeatedly.

Combo of Arnica/Rhus/Ruta.

 

Um, I was homeless and some guy at some free clinic "muscle tested" me for rhus... and it gave me weird huge rashes all over my body...so I took more, because he told me it was a detox reaction... and it got worse... and I took more... and it got worse... and I stopped taking it and it went away. But it ruined my job at this ranch in New Mexico--I couldn't do the work. Then again, arnica always gives me bruises, too... lol.. The only thing that has worked for me is using that drawing remedy topically when I got a mesquite thorn stuck in my foot and had this scary travelling red line. We used some drawing homeopathic in water along with mesquite salve and...a hell of a lot of prayer... it worked! Which is good, because I was living in a tent in the desert!

[三江源]

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Edited April 23, 2015 by 三江源

[karen]

Yael, sounds like you're particularly sensitive to those remedies, or you had too low a potency. When someone's particularly sensitive, it's good to put a dose in a little water and sip a number of times throughout the day. Or even start by just sniffing the remedy (Dr. Hahnemann called that the "olfactory method" and used it clinically quite a lot).

 

Cat, with EFT even though you may start by stating the symptoms because that's what you're aware of, that process can take you to the false beliefs and fears that can be causative. How well EFT can remove them depends on how deeply the belief has penetrated into the organs. For example, if you're depressed and the disturbance is lodged in your liver, you might be able to release it partially with EFT but then other remedies would also be needed.

 

Also, most people have many other blockages to clear before they can access the core level false beliefs. I wouldn't rely on EFT alone to resolve deeply ingrained issues. The release you get is going to help just about anything, but without true diagnosis and targeting treatment to the specific disease entities, in the proper sequence, you really don't know from a medical standpoint what's being accomplished. Then you can only judge the situation according to symptoms, but that doesn't tell us much about the disease process.

 

So, for a quick do-it-yourself method, EFT shines, but for complex health issues it's not enough.

 

Re. "so many interventions" - it really does make one bug-eyed to say the least! This is why I use the Heilkunst system, because its not just another type of therapy to add to the multitude we already have, but an overall map of where they all fit. Most people are looking for the right therapy, focusing on the forms of all these therapies and trying to figure out which form is best. It becomes a very convoluted process without an organizing system.

[Lozen]

The weird thing about my elbow pain is that it seems to be my arm now and directly traces the channel, apparently. So I got more acupuncture and Tieh Ta Formula (which is like internal dit da jow). Oh yeah, and I was prescribed to go buy a scarf to keep the back of my neck warm, which made me happy. I'm gonna go find a cool one. I just had to share this. So it's really not about ice versus heat, it's about ice or heat versus scarves!

[Lozen]

Okay, I got rhus, ruta and arnica when they were on sale at Wild Oats (all three for around $15! and then I found the perfect mitten/gloves that are wool and soft and pink and lovely for $12!! god loves me!!!!)

 

Anyway, I hope I got the right potency. They had 6c and 30c and I went with 6c. I hope that's right... We'll c!

[karen]

Good deal! 30C would be best, but 6C is okay. Just take it more often, and whack the vial hard against your palm (with lovely mittens off) a few times before taking.

[Lozen]

Good deal! 30C would be best, but 6C is okay. Just take it more often, and whack the vial hard against your palm (with lovely mittens off) a few times before taking.

 

Whack the vial against my palm? Is that to make sure I feel traumatized first? lol

 

How often do you take them, and is it okay to chew the pellets? And how many pellets?

 

I did one of each last night, this morning, and again after training today. I can't tell if it's better or worse, lol.