from Hydrothermic Remedies...
"When the body has long remained in contact with cold substances, such as cold air and cold water, the real effects of the cold are seen. If the body becomes thoroughly chilled, its various functions are slowed and depressed....
"If, instead of becoming chilled, the body remains in contact with cold water or cold air for only a brief time, its activities are heightened instead of slowed or depressed." Elements of Hydrotherapy for Nurses, p. 19.
A local application of cold (ice bar) over a body segment.
- Blood flow to the part is greatly decreased at first, then greatly increased with exercise after the ice massage.
- The cold causes contraction of the blood vessels. As a consequence the part cools deeply since circulation is prevented from warming the part with fresh warm blood.
- The metabolism of tissues when cooled is decreased according to the Van't Hoff principle. That is the use of oxygen and all nutritional substances as well as the production of carbon dioxide and all waste products is decreased. But more important cellular activity is decreased including that of the nerves. Thus there is decrease of the sensation and even anaesthesia.
- Since pain sensation is decreased the part treated with ice massage can be exercised, stretched, and massaged where as without the cold treatment there would be too much pain.
- Acute Joint Pain and adjacent tissues, such as Bursitis
- Acute Muscle Pain and Muscle Inflammation, such as myositis. Other soft tissue inflammations such as Strain
- Acute Neck Pain and Back Pain
Contraindications or Cautions
- When patient is cold
- Painful shoulder or stroke
- Rheumatoid arthritis
- Shoulder-hand syndrome
- Very painful inflammation. Use the Ice Pack instead.
- 2 pillows
- Plastic sheet
- 4 Bath towels
- 1 pair of mitts
- 1 or 2 glasses or foam cups of ice
- Do not rub directly over a bony prominence.
- Do not let patient get chilled.
Preparation for Treatment
- When treatment is to be given to the back we recommend this procedure: have the person lie on stomach with pillow under the abdomen and one under the feet with a small towel or pad under the face.
- Drape the patient so that only the area that needs the massage is exposed.
- Take the ice out of its container, or peel away part of the foam cup to expose ice and hold firmly, with the mitt on as required.
- Rub your dry hand on the area that ice is to be applied to reduce the initial chill of the ice.
- Note the time treatment begins as it must continue for 15 minutes.
- Rub ice in a massage motion over the painful area and a little way beyond it on all sides; keep the ice in continuous motion.
- The person will experience four stages;
- Cold, uncomfortable sensation;
- Burning feeling;
- Aching of short duration;
- Relative numbness (about 7-10 minutes usually); continue until 15 minutes since the start of the treatment; the area should be pink in colour.
Completion of Treatment
- Following the ice rub, the person should do resistive exercises for the area treated, thoroughly planned exercise involving every muscle around the painful part of the body. This is the most valuable part of the treatment.
- The part can be massaged. Deep heavy movement may be of great value.
- Once in a great while a second icing treatment is necessary. Usually results should be seen after treating the area daily for 3 days.