R.I.C.E. Treatment Is Recommended for Acute Musculoskeletal Injury

R.I.C.E. Reduces Pain and Swelling

Applying ice pack to injured ankle
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The R.I.C.E. treatment is prescribed by health professionals for the early treatment of acute soft tissue injuries, such as a sprain, strain, or bone injury. It can be helpful for sports injuries, closed fractures, and degenerative joint problems. The acronym R.I.C.E. stands for:

  • Rest
  • Ice
  • Compression
  • Elevation

The primary goal of R.I.C.E. is to bring pain and swelling under control as quickly as possible.

It should be started as soon as pain and swelling occur and used until there is healing of minor injuries or until other treatment has been initiated for more complex problems.

Rest

Rest is needed for the healing of injured tissue. Without rest, movement and weightbearing can continue to aggravate an injury and cause increased inflammation and swelling. You should reduce or stop using the injured area for 48 hours initially. If you have a leg injury, you may need to stay off of it completely (i.e., non-weightbearing). You may need to use assistive devices or mobility aids to keep off of the injured joint or limb. 

Ice

Ice is useful for reducing pain and inflammation associated with an acute injury. Ice can be applied for 20 minutes at a time, as frequently as every hour if tolerated, or 4 to 8 times a day if preferred. Icing is most effective if done the first couple of days after the injury has occurred.

You can use a cold gel pack or a plastic bag filled with ice, but do not apply a bag of ice directly to the skin. Instead, wrap the bag of ice in a towel or make sure there is some layer of material between ice and skin. Gel packs or cold packs sold for this purpose already have a cover provided.

Compression

Compression of an injured or painful ankle, knee, or wrist helps to reduce the swelling.

Elastic bandages, such as ACE wraps, are most commonly used. Special boots, air casts, and splints can serve a dual purpose of compression and support. Your doctor should make a recommendation and discuss your options. Be sure not to apply excessive compression which would act like a tourniquet and interfere with circulation.

Elevation

The injured part of the body (e.g., leg or ankle) should be elevated above heart level (approximately 6 to 10 inches above, according to Family Practice Notebook) to optimize venous return to the heart. Lay down and use a pillow to help elevate the injured limb.

When to Seek Medical Treatment

Get professional treatment if any injury is severe. A severe injury implies that there is an obvious fracture or dislocation of a joint, prolonged swelling, or prolonged or severe pain. While many common acute injuries can be helped by R.I.C.E., especially when combined with over-the-counter pain relievers, more serious conditions may require more intensive treatment and possibly surgery, in some cases.

Too often, people with an acute injury do nothing, with the hope that it will go away without any intervention. But, bringing pain, swelling, and inflammation under control as soon as possible is the optimal plan.

Sources:

Preventing Musculoskeletal Sports Injuries in Youth: A Guide for Parents. NIAMS. September 2016.

RICE Therapy. Family Practice Notebook.

Singh A.P., MD RICE Therapy - Rest, Ice, Compression, Elevation. Boneandspine.com. Edited February 11, 2016.
 

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