Medical questions & health advice by board certified doctors
"Should I apply heat or cold to a pulled muscle?"
I think I pulled a muscle in my arm. Should I put heat on it or cold? How long? If I do this again in the future, what is the best way to help it heal quickly?
In the acute phase after a muscle strain, ice is better than heat. However, you should be evaluated by your primary care physician to ensure there are no other worrisome features to your injury. A way to remember the appropriate steps to treat muscle strains is RICE (Rest, Ice, Compression, Elevation). Rest is important because without it you can cause more strain to the area, leading to more inflammation and possibly further injury. Ice is wonderful for strains and bruises because it not only helps relieve pain, but also decreases the inflammation within the muscle. To use ice appropriately, you should place it on the affected area for about 20 minutes and then let the area relax. You can wrap the ice in a paper towel or thin towel so that the ice is not directly on the skin. However, you do not want to overuse ice because it can lead to decreased blood flow to the area. Compression with an ACE bandage can help decrease swelling from the inflammatory process, but again, you do not want to overuse compression or wrap the area too tightly because you can decrease blood flow. Lastly, elevation of the affected arm above the level of your heart will help decrease the swelling. This works by increasing blood flow back to the heart instead of allowing it to pool in the arm. Even though these treatments can help with symptoms, you should follow up with your primary care physician to ensure there are no other worrisome symptoms.
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