Sunday, March 27, 2011

Icy-Hot Patches Do Not Replace Ice Packs or Hot Packs

By Miami Beach Florida Chiropractic Sports Physician - Dr. Todd Narson

I'm really getting tired of people listening to TV commercials and "interpreting" my advice. I'm sure I'm not the only doctor this happens to either.

So someone comes into my office here in Miami Beach with a particular complaint. Shoulder (rotator cuff) pain, back pain, neck pain, knee pain, I.T. band pain, plantar fascitis, carpal tunnel syndrome, tennis elbow, golfer's get the idea. I do an exam and then make my recommendations for treatment in the office and what they need to do at home to help.

I will recommend applying an ice pack for 15 to 20 minutes for 3, 4, 5, or more times per day. Or, if the condition requires heat, the recommendation is a moist heating pad for 20 minutes several times throughout the day as well. Then, on their next visit when I ask how they're doing? - they say they aren't getting any better. I question them about following my home recommendations and invariably find out they are using some type of "pain patch" or topical pain relief cream that "feels" cold or "feels" hot.

The problem with these pain patches that people Like Shaq and others are paid to sell on TV is that their one and only purpose is to mask your pain. They are very simply skin irritants that will distract you from feeling pain by a chemical perception of heating or cooling. some of them may have some interesting ingredients to help it "get down deep" but they don't get into the muscles, they don't go into the joints. They sit on the surface, smell horribly and don't do anything to reduce inflammation or spasm.

When I make a recommendation for using ice or moist heat, I mean apply an actual ice pack or an actual moist heating pad. Both of these have specific physiological effects that will help inflammation, spasm and pain. They have specific effects that will help your condition heal.

So, when I or your physician, therapist or trainer tells you to apple ice or apply heat, we're talking about the real thing. Save the topical stuff for when you leave your home. Yes, they will make you "feel" better but they don't help you actually get better.

I your bicycle is broken you can certainly paint it to make it look better, but unless you fix it, you still have a broken bicycle. Stop listening to Shaq and his TV commercial with his pain patches and take the advice from a real doctor. Afterall, when Shaquille O'Neal gets hurt, he goes to his team physicians and trainers, not the box of pain patches.

'nuff said

Dr. T

PS, if you're a physician, PT or ATC, please chime in here. I'd love to hear your thoughts on this.

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.


Unknown said...

Dr Narson,
Agree with your points about topicals and direct application
of ice.
A decade ago I was approached by a Medical Marketing company to test a new product and give them feedback. The product ended up being the heat patches that are readily available OTC. I didn't think all too much about their effectiveness at that time and nothing has changed since. Most patients are not too hip with icing but once they do it they never go back to heat or patches.
Really enjoy your blog.
Dave Marcon, DC, CCSP, NSCA-CPT

Unknown said...

Dr Narson,
You asked for comments so hear it goes.
I agree with the thoughts on topicals vs. direct application of ice/heat. But, there is definitely a place for topicals. If I can keep a patient from medicating as a first line therapy and engage them enough to apply a topical 2-3x per day in addition to ice then compliance is up and results progress faster.
Incidentally, I was a paid consultant for the heat patches many years ago. I didn't give them high marks then and nothing has changed my mind. At the time I recall being interview for an hour by a panel which was behind a two-way mirror. I was adamant that heat had such a small window of application vs. ice in the treatment of injuries.
When in doubt use Ice!
Great blog. I just came across it while researching FAKTAR.
Dave Marcon, DC,CCSP, NSCA-CPT