Copyright 2002, E. Franklin Livingstone, M.D.

Cold therapy is one of the most powerful physical medicine modalities of treatment that we have easily and inexpensively available. It is extremely useful in acute injury and in chronic muscular pain syndromes. Not only is it powerful, but is safe when used properly. With the proper instruction, you can use this at home, on your own, at any time you decide.

There are few contraindications to cold. There is a rare condition of the blood called "cryoglobulinemia" which is a contraindication to the use of cold therapy. In addition, peripheral vascular disease, where blood flow is insufficient to maintain healthy tissues is another contraindication. Sometimes, the use of cold over a non-inflamed arthritic joint can caused increased stiffness and discomfort.

Cold therapy is effective in the treatment of pain and inflammation. In the case of conditions where inflammation is a factor, cold therapy can reduce inflammation and the swelling that is caused by the inflammatory process. In addition, cold therapy penetrates skin and tissue better than heat therapy. It should be noted, however, that cold therapy can cause increased muscle tension initially, during application.

The easiest methods of providing cold therapy for yourself are commercially available gel cold packs or simple ice packs that can be made at home. In addition, further on you will find a recipe for a homemade cold pack. By far, the most effective and convenient are the gel cold packs that are available under the brand name "Colpac." These are dark blue, plastic covered cold packs that are very durable and useful.

There are four general guidelines to using cold packs effectively and safely. First, store your cold packs in a refrigerator freezer not in a deep freezer. When you use the cold pack, put one layer of cloth between your skin and the cold pack, preferably terry cloth such as towel. When you are treating chronic muscular pain or inflammation, you should use the cold pack for 20 to 35 minutes depending upon the depth of the skin and subcutaneous tissue. You may use the cold pack fairly often, but you should give yourself at least two hours in between cold pack treatment sessions.

The following is a recipe for making gel packs at home:


You will need:
One gallon, zip-lock food storage bags (two per cold-pack), Isopropyl alcohol (rubbing alcohol), and water. Into a food storage bag pour (one half) cup of isopropyl alcohol and 1 (one and one half) cups of water. Then seal the zip-lock closure almost completely, but not quite (leave about two inches open). Force as much of the air out of the bag as possible before completely sealing the zip- lock closure. When you have done this, place the sealed bag with the fluid into another zip-lock bag and seal it the same way, eliminating as much air from the bag as possible. The second bag is for strength and to prevent a mess if the bag with the fluid should rupture.

Store your homemade cold-packs in your refrigerator freezer (DO NOT STORE IN A DEEP FREEZER UNIT). When your cold-pack is "frozen" it will not be solid like ice, but pliable and
will better conform to body surface shape. You will need to use two or more of these cold- packs at a time, depending on the size of the area being treated, and you will need to have the cold-packs two or three deep for best cold therapy.  USE YOUR COLD PACK FOR AT LEAST TWENTY MINUTES, AND YOU WILL NEED MORE TIME IF YOU HAVE T THICK FAT OVER THE MUSCLES OR LIGAMENTS THAT YOUR ARE TREATING. Thirty minutes is often enough time, but more will usually not hurt. Give yourself about two hours between old -pack therapy sessions.

If you are treating a painful condition, use the cold-packs regularly, four to six times per day and don't always wait until you hurt to use them. Set specific times during the day to use your cold packs, and use them whether pain tells you to use them or not. LIE DOWN ON THE COLD-PACKS ( If you are treating an area on the back side of your head/body) WITH ONE LAYER OF TOWEL BETWEEN YOUR SKIN AND THE COLD-PACKS.



Copyright 2002, E. Franklin Livingstone, M.D.

Permission is granted to use this information for personal use. Any other use requires expressed written permission from the author.