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City Acupuncture's Blog

Ice Or Heat: Discovering The Secret To Knee Pain

Posted by Rob Benhuri

Mar 25, 2014 6:00:00 AM

To Ice Or Not To Iceknee-pain

If you remember falling at the playground as a child or getting injured while playing sports, you likely remember being offered ice to remedy your soreness. While ice is certainly great to numb an area to "forget about the pain" is it really that effective therapeutically? You may be surprised to learn from a Chinese medical perspective we almost always say no! If you're suffering from any type of knee pain, read on as we explain why heat may be more of a friend than you realize!

How Heat Effectively Soothes Knee Pain

If you're a runner, you're likely no stranger to sore knees, and to occasionally icing them. The constant pounding of the pavement creates tension, restriction and inflammation that often leave knees feeling sore and sometimes painful. For many, ice seems like the natural go-to to quell this inflammatory process. Those suffering from chronic knee pain, perhaps from osteo or rheumatoid arthritis often grab the ice-pack during a flare up. Sure, the ice makes it all feel better temporarily, but turns out, it may actually be impeding the healing process. Let's explore why.

Imagine a pipe that partially freezes during the winter months. The section of the pipe subjected to the ice may slow down flow of whatever regularly passes through or in completely frozen situations, flow may be entirely impeded on either side. With improper facilitation of flow, what needs to make it from point A to B to C and so on gets backed up, pools and in some cases creates damage because it has nowhere to go.

The same is true when we apply cold to our joints. Apply an ice pack to your aching knees and you're potentially creating this same blockage that occurs in the pipes. When we're experiencing pain and discomfort, the body intuitively sends nutrients and anti-inflammatory bio-chemicals to the site to help speed up healing. The addition of ice over an area slows and impedes necessary facilitation of these helpful pain regulators. When nutrition can't reach the joint space, your knee often suffers from ongoing stiffness, aches and in some cases range of motion and stability issues.

Circulation to the knee is key to help reduce and eliminate pain over time. While it may seem counterintuitive to add heat to inflammation, heat softens tissues and encourages circulation of nutrients and healing bio-chemicals to the affected area. Chinese medical theory supports the idea that flow of nutrients to one affected area will have a positive effect on the surrounding areas because the body operates as one, interactive organism. If the tendons, ligaments, muscles and fascia such as the iliotibial band around the knee become stiff from adding too much ice, cold can become "lodged" in the joint. The result is often experienced with sore hips or ankles and occasional muscle spasms.


A 2013 study showed that immediate application of heat, moist or dry, effectively prevented delayed onset muscle soreness. This suggests that heat is more ideal as your go-to for knee pain. If you must apply ice because your pain or level of discomfort is unbearable, we suggest surrounding the affected area that you've applied ice to with heat packs. The addition of the hot packs will allow nutrition to effectively circulate to the knee still without compromising associated support structures.

In some instances you may find that heat agitates your knee and the affected area. Not to worry- there are still alternatives to ice. In this case we suggest the use of herbal soaks and poultices. Both soaks and poultices are readily available and easy to apply. Your acupuncturist can create an herbal soak specifically for your needs. Over the counter applications are also available that you can pick up from our herbal pharmacy. Soaks can be applied directly by bathing the affected area or by wrapping the area in gauze treated with the herbal preparation. These herbal applications act to heal tendons, ligaments, fascia and muscles by encouraging metabolic waste to flow to the lymph system for elimination. They will also promote blood circulation of nutrients that help your knee pain heal.

A noteworthy review of the research supporting heat for knee pain is its effects on overall wellbeing. If you suffer from ongoing knee pain, you'll be happy to learn that those persons who applied heat every other day to their knees reported overall improved quality of life and diminished pain.


Topics: Acupuncture, Runner's Knee, Knee Pain

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