Published: July 20, 2016 | Updated: November 21, 2023
Amid the bumps, bruises and sprains of childhood, it can be confusing when to use ice or heat for an injury.
Applying ice is a safe and effective way to help with swelling and pain. It can be go-to first aid for a variety of minor injuries, according to Jennifer Brey, M.D., pediatric orthopedic surgeon and sports medicine specialist with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine.
“There’s kind of a myth out there that you should ice for 24 hours then heat after that, and that’s not at all true,” Dr. Brey said. “I very rarely recommend using heat. It’s important to use ice consistently for minor injuries.”
With offices throughout the Louisville area, a Norton Children’s Medical Group pediatrician office isn’t far.
“For injuries such as these you want to use ice, but follow what is known as the RICE method,” Dr. Brey said.
RICE stands for rest, ice, compression and elevation.
Rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury.
Ice provides short-term pain relief and limits swelling by reducing blood flow to the injured area. Never put ice directly on skin. Wrap a bag of ice in a towel and leave on for no more than 20 to 30 minutes.
Compression also helps to reduce swelling. Wrap an ACE bandage around the swollen area to provide compression. According to Dr. Brey, the bandage may be left on for as long as needed.
Elevating the injured part of the body helps control swelling as well. Elevate as long as needed for the swelling to go down and pain to be relieved.
RICE may be done as much as needed after an injury, whether it is for 24 hours or one to two weeks,” Dr. Brey said. “If pain is not improving after that long, medical attention should be sought.”
Abrasions are injuries to the skin. Wash these areas with soap and water, then apply ice for pain relief.
“Place a clean towel on top of the abrasion, then put the ice on top of that. Don’t put the ice directly on the wound,” Dr. Brey said. “Abrasions may be covered with clean gauze or an ACE bandage, or if they are not draining clear fluid, may be left uncovered.”
Abrasions rarely get infected, but always keep an eye out for signs of infection: increasing pain, yellow or thick drainage, or redness that is spreading.
Antibiotic ointment, such as Neosporin, may be used to help prevent infection.
Are those “icy” and “hot” ointments adults use for aching muscles safe for a child?
“Some of these muscle rubs contain the ingredient capsaicin, which can help with aches and soreness,” Dr. Brey said. “They are likely safe for kids, however nobody’s really done studies and there’s not a lot of data on it being used on kids. If it helps, great; and if it doesn’t help, don’t use it. Every child is going to be different.”
Dr. Brey cautions against using these topical rubs on babies or very young children due to the possibility of skin irritation. She suggests using them only on children age 6 and older, however watch for skin irritation on these children as well.
For parents who prefer homeopathic remedies, such as essential oils, to soothe the pain, Dr. Brey hasn’t seen them provide any better relief than applying ice, but if it makes a child feel better, go for it.
When does your child’s injury need something more than rest and ice?
“If your child has pain that isn’t relieved by an ice pack and a few days of rest or if swelling persists, the injury should be looked at by a doctor right away,” Dr. Brey said.