ICE: Just 5-7 minutes with ice and a damp paper towel

Almost everyone knows the acronym RICE (Rest, Ice, Compression, Elevation) when it comes to injuries, especially acute injuries, but the missing part is how to apply ice. Oddly enough, there is a better method for frostbite injuries. The best method of icing a lesion is through direct skin contact with a damp paper towel on the outside of the bag.

Before I go on to explain why this is the best method, I want to talk about ice packs. Most reusable ice packs from a drugstore are at the temperature of your freezer, which is usually below freezing. At first this may seem like a good thing because it’s colder, but there is a (low) risk of skin damage (mild frostbite) with the use of these ice packs. Also, as soon as the ice pack comes into contact with something warmer, it starts to rise in temperature. After just a few minutes of icing, the temperature of the gel in contact with your body is warmer and gradually acts as a buffer for the still frozen gel. In order to have an effective ice treatment with an ice pack, it needs to stay on the skin for 15 to 20 minutes.

So now that you know that ice packs are not that efficient and pose a slight risk, I’ll explain why it’s the method I described above. First, there is no risk of damaging the skin with ice because it is never at freezing temperature when in contact with the skin. The thin layer of liquid water on the outside of the ice is just above freezing and is highly unlikely to ever cause any skin damage. Second, the wet paper towel enhances the distribution of the cold effect, and the moisture from the wet paper towel moves heat transfer away from the body more efficiently than dry air (ice pack). This is similar to when someone falls into a frozen lake. When treating such a person for hypothermia, the first thing to do is remove all wet clothing. Of course, you may wonder why you can’t just put the wet paper towel on top of the ice pack. I tried this and the ice pack, because it is below freezing it will freeze the wet paper towel and you will lose the effect of the moisture.

Due to the improved efficiency of this icing method, the time you have to spend with the ice is dramatically reduced. If the ice is simply resting on the body part, it needs to stay there for 7 minutes to be effective, and if you’re lying down you only need 5 minutes. Of course, you can apply ice for a longer time if you wish, as there is little to no risk of tissue damage.

If you are applying ice to smaller areas or hard-to-reach places (fingers, toes, sharp points, etc.), then you can use ice massage with similar effects to the previous method. The easiest way to do this is to take a small paper cup, fill it 3/4 full with water, and freeze it. Once frozen, you can tear off the top half of the cup and use the ice to massage the targeted area. Since ice is more direct, you only need to do an ice massage for 3-5 minutes.

The other point I’d like to make regarding ice is that it’s not just for acute injuries, it can be for chronic injuries as well. With acute injuries, icing is applied to control pain, swelling, and inflammation, and the purpose is no different for chronic injuries. Chronic injuries still have pain, inflammation, and swelling. Additionally, chronic injuries have reduced blood flow which reduces the supply of oxygen and nutrients, which are two key components of healing. Icing an injured area increases blood flow because the body is trying to warm the area and it does so by forcing more blood into the constricted tissue; therefore promoting healing.

Creating a regular schedule of icing (at least morning and night) for any orthopedic injury helps control swelling, pain, and inflammation. It also helps deliver more oxygen and nutrients to help with the healing of damaged tissue. So go to your nearest store, pick up some ice trays, plastic bags, and a roll of paper towels to help treat just about all of your musculoskeletal aches and pains.

If you know of any negative reactions to cold, such as cold urticaria or Raynaud’s phenomenon, see your GP.