The purpose of ice applications is to reduce nerve irritation, swelling, and inflammation in the joints and tissues. It is useful in the earlier period of the injury when pain is the overriding symptom. Do not use heat or heat salve when ice has been recommended. Similarly, avoid baths and hot tubs in the early phase of treatment. Showers are acceptable for short periods, but
often will want to be followed by ice.
Apply ice to the affected area for 20 minutes, then remove the ice for 40 minutes. This guards against over icing which can freeze or frostbite the tissues. After 40 minutes, ice may be applied again, and commonly, it will be recommended to walk short distances between periods of icing. If walking is painful, crawling may also be employed between icings to lightly pump the affected joint without weight bearing.
When preparing for multiple applications of ice, it may be most convenient to soak a hand towel with water and seal it inside two zip lock bags, placing the bagged towel in the freezer. When used, the towel will gradually thaw, allowing it to better shape itself to the body. Packages of frozen corn or peas can also be creatively used as ice compresses.
While applying ice, it is best to sit in a supportive chair with the ice behind the low back, or with the low back supported while ice is applied to the upper back. Soft chairs or couches are not recommended as they will generally worsen the condition. If lying down is the only comfortable position, then lying on your side with the ice sandwiched between you and a wall , or between you and the base of a couch is recommended. Lying on your back with the ice below you is never recommended in the acute phase, as this will usually aggravate the stresses on the joint, worsening the condition