克利夫兰医学中心:酸痛、受伤,冰敷还是热敷?

肌肉拉伤、韧带扭伤、关节痛、头痛等,除了服用 OTC 止痛药,外敷也是一种辅助治疗手段。然而,什么时候冰敷,什么时候热敷呢?克利夫兰医学中心对这个问题作了介绍;一句话概括:发炎肿胀时用冰敷,改善肢体功能时用热敷。

急性损伤 / Acute injuries

扭伤、挫伤、跌伤或撞击伤等等都属于急性损伤:

  • 6 周以内的急性损伤,通常应用冰敷,可收缩血管、减轻疼痛,同时减轻发炎和瘀伤。
  • 6 周之后的此类损伤,可以用热敷,增加血液流量,使紧绷的肌肉放松、减缓关节疼痛,尤其有益于帮助受伤的关节恢复活动能力。
  • 热敷可改善肢体活动障碍,所以在恢复性锻炼前,可先热敷;锻炼过后再用冰敷、预防发炎。
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关节炎 / Arthritis

关节炎或软骨磨损造成的关节发炎,会导致肩肘、膝盖和手指等部位疼痛僵硬,可用湿热毛巾热敷,也可在浴缸中以温水浸泡,或温水淋浴。湿热会让患处感觉更舒服。

痛风 / Gout

痛风发作时会引起关节疼痛,冰敷可帮助平息发作,减轻痛感。

头疼 / Headaches

较轻程度的头痛,可服用 OTC 止痛药。如果头痛比较剧烈,或止痛药无法快速起效,可用冰敷缓解疼痛;将冰贴贴在额头、眼睛和太阳穴位置即可。

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然而,如果头痛是由于颈部神经痉挛而引起,缓解颈部痉挛不能用冰敷,要用热敷。

肌肉拉伤和扭伤

肌肉拉伤扭伤(muscle strains and sprains)通常需要冷热结合。和急性损伤类似,先从冰敷开始,减轻炎症,如肿胀、发红或压痛等。等炎症消退再改用热敷,使受伤部位的肌肉得到放松。

肌腱炎 / Tendinitis

肌腱炎是指发生在肩肘、膝盖、臀部以及跟腱中的肌腱位置的炎症。这是一种 (超级疼) 的炎症疾病,别问我如何知道,自然是有过切身体会。肌腱炎的治疗手段通常是服用 OTC 止痛药来消炎镇痛,同时尽量让患处保持不动,让患处得到充分休养。如果疼痛过于剧烈,止痛药也没法很好的减轻痛感,可以采用冰敷来辅助治疗。

肌腱病 / Tendinosis

尽管名称相似,但与肌腱炎不同,肌腱病是由肌腱退化而引起的慢性疾病。因为肌腱通常需要很长时间才能愈合,所以肌腱病的病程也会持续较长时间。肌腱病会引起关节肌腱部位僵硬,热敷可以帮助缓解。但如果患处有炎症,还是先要冷敷来促进炎症消退。

如何冰敷或热敷?

克利夫兰医学中心建议,外敷持续时间不要超过 20 分钟,两次外敷中间间隔 20 分钟。外敷可以用专业的医用凝胶贴,Amazon 上就能买到,还能反复使用。有些产品还可以根据需要进行冷冻或加热,这样就既可以用来冰敷,也可以用来热敷。

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如果临时找不到医用冰敷贴,也可以用未开封的冷冻豌豆粒或玉米粒。如果受伤的部位在肘部或者脚跟的位置,冰袋比较不容易贴合患处,可以用一次性纸杯装上水放到冰箱里冷冻,之后对患处进行按摩直到患处感觉麻木。

专业热敷理疗会用到石蜡,但容易过热导致灼伤。石蜡热敷的消耗比较大,所以费用也比较高。

此外,神经病 (neuropathy) 和雷诺氏综合症 (Raynaud’s syndrome) 患者可能会有局部区域感觉神经下降的问题,对极端温度的感觉不敏感,因此在进行外敷时要更加谨慎,严格控制时间。

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