At various points in our lives, we all experience musculoskeletal pain. It may result from physical overuse, injuries, illnesses, arthritis, stress, or excessive exercise.
Musculoskeletal pain arising from severe injuries or health conditions usually requires care from medical professionals. However, when musculoskeletal pain arises from minor injuries or conditions, it can often be alleviated with care at home.
With home care, our first instinct may be to take it easy. We’ll use the RICE home remedy method (Rest, Ice, Compression, and Elevation) to help minimize pain, inflammation, and tissue damage.
However, recent medical studies suggest that the RICE approach might delay healing. Instead, many doctors and physical therapists now recommend new therapies. These therapies focus on gentle movement and limited use of ice rather than strict rest. This encourages healing blood flow to the location of the injury.
These new approaches are sometimes coupled with additional medical treatments to help unlock and accelerate the body’s natural healing processes.
Viewing Pain Not as a Problem, But as a Means for Healing
Pain is a warning signal that alerts us to a threat to our body, helping us to survive. Pain can alert us to harmful changes in the body, like a fractured bone, or help us learn how to avoid something harmful, like overstretching a tendon. It helps keep us safe.
When an injury occurs and our body experiences pain, it usually triggers an inflammatory response. This is a crucial first step in the healing process. The pain itself causes us to protect the injured area, which helps prevent additional harm. With this inflammation, our body directs natural healing resources to repair damaged tissue and promote regeneration.
There are key differences in how the body responds to pain, depending on whether it is acute (short-term) or chronic (persistent).
Acute pain can be mild and short-lasting. We may experience acute pain from a twisted ankle or a pulled muscle. It serves a protective role and typically resolves once the underlying issue heals.
Chronic pain can last many months or longer. It may result from conditions like a torn ligament or arthritic spine deterioration. Chronic pain can occur without a known cause and persist even after an injury or a known underlying condition is resolved.
While acute pain usually stimulates a healing response from the body, chronic pain can disrupt healing by causing stress and inhibiting tissue repair. It follows that while acute pain usually responds to home care treatment, chronic pain relief generally requires help from a medical professional.
If you have musculoskeletal pain coupled with trouble breathing, dizziness, a high fever, or a severe injury that prevents movement, don’t hesitate to seek immediate medical care.
Why Alternatives to the Traditional RICE Home Treatment Protocol Are Now Being Recommended
According to current studies, where does RICE fall short, and how can acute-pain home care be improved?
Let’s Start with the ‘R’ in RICE – Rest.
The traditional thinking behind resting after an injury is to allow your body to regroup and send natural healing resources to the injury site. However, it is now believed that the healing process can be accelerated more quickly with gentle movement.
Resting can be important in the first 12 to 24 hours after an injury. However, after that, many doctors now recommend gently moving the injured area as soon as possible. This approach helps prevent muscle shortening and promotes healing blood flow to the injury site.
With this gentle movement, it’s essential to use common sense. Use the pain level you experience with movement to guide how far you should progress with an injury.
What about Ice, the “I” in RICE?
Ice encompasses any cooling therapy, including the application of ice packs, an ice water bath, or other methods. Cold causes your blood vessels to constrict and numb your tissues, reducing pain.
However, for minor injuries with low to moderate pain, many doctors now believe that inflammation usually isn’t something you should focus on suppressing. As discussed, inflammation is part of our body’s natural healing mechanism.
Using ice on an injured area interferes with this natural response by reducing blood flow and slowing the healing response. Some studies have also indicated that ice may kill muscle cells.
It’s now recommended that if you use ice to reduce pain and swelling, use it only for a few minutes within the first few hours of sustaining an injury. After that, you should avoid suppressing your body’s natural healing processes.
A Selection of New Acute Pain, Home Care Treatment Options
With the current evolution of thinking on acute pain treatment protocols, there are a variety of options beyond RICE. Three of them are known by the acronyms MEAT, PEACE and LOVE, and RACE. We’ll take a short look at each of them below.
MEAT (Movement, Exercise, Analgesia, Treatment)
Some medical professionals now recommend the MEAT approach for home treatment. MEAT stands for movement, exercise, analgesics, and treatment.
Immediately after an injury, gentle range of motion movements will increase circulation to the area of injury. This will also help prevent the formation of scar tissue or adhesions around the injured body part.
Once you can tolerate gentle movements, low-resistance strengthening exercise is recommended. This will help further increase circulation in the injured area and reduce muscle atrophy and joint stiffness.
Analgesia refers to the use of medications or other protocols to block pain and reduce inflammation during treatment. The use of NSAIDs such as Advil or ibuprofen should be minimized as they suppress inflammation – and a degree of inflammation is needed to promote healing.
Other forms of analgesia include ice (but only for short periods), topical creams that desensitize the area (if there are no open wounds), and over-the-counter medications such as acetaminophen (Tylenol). However, before using any analgesia treatment methods, check with your doctor to ensure they are safe for you to use.
Finally, corrective exercise, manual therapy, joint mobilizations, and myofascial release are all treatment methods that can help you accelerate your recovery. Consulting with a healthcare professional, such as a Physical Medicine and Rehabilitation Physician, Physical Therapist, Chiropractor, or Registered Massage Therapist, can offer customized plans tailored to your injury.
PEACE (Protection, Elevation, Avoiding Anti-inflammatories, Compression, Education) and LOVE (Load, Optimism, Vascularization, Exercise)
Using medications to control pain may not be appropriate for those with certain existing medical conditions. Others may want to avoid analgesic treatments altogether to preserve the healing benefits of inflammation. The PEACE and LOVE approach may be a good alternative in these cases and others.
With PEACE, the approach is about finding a pragmatic balance. It’s about protection – not doing too much, too soon, while still doing enough gentle, functional movement to preserve your range of motion. While exercising, you seek to minimize the weight and pressure on the affected area.
As part of this protocol, you avoid using anti-inflammatory medications, thereby allowing the body’s natural healing processes to take effect. Education is critical; the more you know about your injury, the better prepared you will be to manage your recovery.
The LOVE approach is often paired with PEACE. With LOVE, you gradually increase the load, or weight, that you place on the injured area as you exercise it. Practitioners believe that a positive, optimistic outlook is also crucial for recovery.
Vascularization refers to the increase in blood flow that occurs with cardiovascular exercises, such as walking, swimming, or biking.
RACE (Recover Actively, Compress, Elevate)
Finally, RACE is a simplified alternative to the traditional RICE protocol.
Recovering actively means that you don’t suppress inflammation, which is the body’s way of initiating the healing process.
The lymphatic system is the body’s natural drainage system. It naturally and slowly removes all the waste products and excess fluid buildup caused by the inflammatory process. The lymphatic system relies heavily on muscle contraction, so early movement is key to faster recovery.
However, while swelling initiates and assists in recovery, excessive swelling can lead to muscle shutdown. Thus, gentle compression with an ace bandage or other compression sleeves can be helpful.
Elevating the injured area can also help encourage fluid to return to the lymphatic system, allowing healing factors to work on the area.
When Low Back Pain Is Too Intense to Exercise
Throughout this discussion, we’ve discussed the benefits of movement and exercise in promoting the healing of musculoskeletal injuries. However, pain can sometimes be too intense for movement, let alone exercise. During these times, consulting a specialist doctor can pave the way for relief.
Intense low back pain is a notable example. Doctors, such as Physical Medicine and Rehabilitation physicians, often recommend physical therapy to alleviate low back pain and prevent future injuries.
Physical therapists will guide exercises to strengthen core muscles, improve flexibility in the lower back and hips, and enhance posture. However, pain levels must be at a level where a patient can tolerate this treatment.
In these cases, physicians may recommend an injection of anti-inflammatory medication, such as a steroid or corticosteroid, into the epidural space surrounding the spinal nerves in the lower back. The goal is to manage pain effectively, allowing patients to participate fully in their physical therapy regimen.
Helping to Accelerate the Body’s Natural Healing Processes
We’ve also discussed how, with inflammation, our bodies direct natural healing resources to repair damaged tissue and promote regeneration. Recent medical advances now offer alternatives to accelerate these natural healing processes.
One such therapy is known as platelet-rich plasma (PRP). PRP therapy involves taking a sample of a patient’s blood. The blood is then processed to concentrate its healing factors, which are subsequently injected into the injury site. For those who respond to PRP injections, it can reliably decrease inflammation and promote accelerated healing.