RICE Therapy – Rest, Ice, Compression, Elevation

RICE stands for Rest, Ice, Compression and Elevation. These four indicates measures taken in the acute setting of injury.

The purpose of RICE therapy is to reduce pain, bleeding and ultimately swelling. Too much swelling interferes with healing [Body has to work to reduce swelling in addition to the original healing process], can lead to complications like skin blisters and compartment syndrome. Swelling can also result in definitive treatment by a few days. For example, fracture fixation cannot be performed unless swelling has reduced because edematous tissue cannot be sutured back in place.

It must be understood that RICE therapy is just a first aid kind of stuff in acute injuries or part of treatment protocol but not definitive treatment in itself. However many minor injuries heal with RICE therapy alone.

RICE is beneficial in closed fractures, sports injuries, and other soft tissue afflictions like muscle spasms, tendonitis, and degenerative injuries. Ice component of RICE therapy cannot be applied to open injuries [injuries with an external wound] but other components can.

RICE therapy should begin as soon as possible and continue till either healing of injury in minor injury cases or till professional health advice is sought.

Rest

Rest is very important for the healing of the injured tissue. A nonresting tissue is further subjected to insults of motion and load. Rest, however, is a relative term and would depend on the severity of the injury.

In general, it implies stopping, changing or taking a break from any pain causing activity.

For example, in a sprained ankle, you need to take the weight off the ankle. The duration of the rest also varies with severity of the injury.

Minor injuries would heal in a few days. Serious injury may warrant seeing a health professional. In such you need to not walk around or put weight on your ankle.

Many aids can help you to provide rest to the part. Splints, walking supports like crutches to keep foot off the ground are such examples. In case of injury to the back, rest is provided by lying down so that load is off the spine.

Without rest, the continual strain on the injured tissue leads to a further increase in inflammation and chances of further injury, eventually making healing of tissue prolonged. Sometimes, the healing could be inefficient leading to abnormal repair or chronic inflammation

Ice

Ice, by virtue of its coldness, helps to reduce reducing the inflammation and pain associated with heat generated by increased blood flow to the injured site. Ice is applied for about 20 minutes every hour. Ice should not be applied directly to the skin and should be placed in towel or polythene or some other material to act as a shield between ice and skin. This is done to prevent injuries caused by direct contact of ice with skin. Readymade icepacks are very good for this and less messy.

Ice should be put on an injury as soon as possible and helps the injury heal faster.

If ice is not available, a bag of frozen vegetables or simple cold water bottle would do the job.

An alternative method of application is to apply ice on for 15 to 20 minutes and remove it for 15 to 20 minutes. Ice should be used as often as possible during the first 1 to 2 days after an injury.

Compression

Compression helps limit swelling to the injured area and provides support to the injured area. Elastic bandage is often used for compression. Splints may carry both the tasks of compressing and providing rest to part.

A compressed site needs to be monitored for the initial few hours to see if the increase in swelling, if any, has led to too much tightening of the compression.

Elevation

If your foot gets injured and you keep it lowered, the heart is able to send more blood to the foot but venous return to the heart is less due to heart being higher and foot being lower]. Elevation negates this difference in levels and increases the venous return to the heart.

It is best to keep the injured part above the level of your heart for maximum effect. For example, in case of the foot injury, lying down and keeping the limb on a pillow helps. But if that is not possible, keeping the lower limb parallel to the ground by putting the foot on a stool or chair would help.

RICE therapy is important to understand as it needs to be applied immediately after the injury for maximum benefit.