RICE is an acronym for a type of treatment. Doctors usually recommend this treatment when a person has injured a muscle, tendon, or ligament. These are called soft tissue injuries.
RICE stands for:
- Rest: Avoiding use of the injured area.
- Ice: Applying ice packs or bags of frozen vegetables to the area, without them touching the skin directly.
- Compression: Wrapping the injured area with an elastic bandage to provide support, reduce blood flow, and limit swelling.
- Elevation: Keeping the area raised above the level of the heart to reduce swelling.
Soft tissue injuries include sprains, strains, and contusions, which are commonly known as bruises.
These injuries are often sports-related. One study reported that sports are responsible for about 50 percent of all musculoskeletal injuries sustained in the United States.
In this article, we describe the correct way to perform RICE and explore why it may be useful.
Share on PinterestAn ice pack may help to numb the affected area, and compression may keep the swelling under control.
The benefits of the RICE method can be explained by stage:
- Rest: Immobilization prevents further injury and gives the body time to recover.
- Ice: Cold reduces pain by numbing the affected area.
- Compression: Pressure keeps swelling under control.
- Elevation: Keeping the injured body part above the heart reduces swelling and the associated pain and discomfort.
A review of studies conducted in 2012 found that there was not enough data to prove that the RICE method effectively treated sprained ankles.
A 2015 review associated with the Red Cross confirmed that ice was effective immediately after an injury. However, the researchers determined that immobilizing an injured limb may not be helpful. They found no evidence to support elevation. They also found indications that compression may not aid strains or sprains.
However, the RICE treatment method remains widely and frequently recommended for a wide variety of injuries.
It is not always necessary to see a doctor before trying the RICE method.
Following the steps below may help to treat a mild or moderate injury. Begin immediately after an injury, and continue treatment for the next 24–48 hours.
- Rest the injured area. Avoid moving it and try to keep weight off it. Use splints, braces, canes, or crutches when available.
- Ice the injury for 20 minutes four to eight times a day. This is especially necessary within the first 3 days. Never allow ice to touch the skin directly.
- Compression is effective for up to 1 week. Wrap the bandage tightly enough to support the area, without cutting off blood flow.
- Elevation reduces swelling and bruising by making it more difficult for blood to reach the injury. Experts say it is best to elevate the area for 2–3 hours a day.
Seek medical care if:
- the injured person cannot put any weight on the area
- the area is numb or misshapen
- the injury is recurring
Always exercise caution when returning to everyday activities.
It is most useful for mild to moderate injuries. Doctors usually recommend the RICE method for:
- sprains
- strains
- bruises
- other soft tissue injuries
People often sustain sprains by tripping, falling, or through sudden twisting motions.
Repeated movements and lifting heavy objects the wrong way can cause strains.
The method is not recommended to treat broken bones or more serious injuries to soft tissue. These may require medication, surgery, or extensive physical therapy.
The RICE method remains the most commonly recommended treatment for soft tissue injuries.
However, not all healthcare providers are completely on board.
Most support the idea of resting, or immobilizing, an injured body part immediately after an injury. Yet, some studies have shown that deliberate, guided movements can be helpful as recovery progresses.
This might involve:
- massage
- stretching
- conditioning
Some physical therapists take a dim view of applying ice and other efforts to prevent inflammation. A study from 2014 suggests that applying ice might actually interfere with the body’s ability to heal.
Injuries are common. Between 2011 and 2014, people in the U.S. reported an average of 8.6 million episodes of injury related to sports and recreation. Luckily, not all were serious. Approximately half required a visit to a doctor or clinician, but not emergency treatment.
The RICE method is best able to treat mild or moderate injuries, such as sprains, strains, and bruises.
If a person has tried the RICE method but experiences no improvement, or if they are unable to put any weight on the injured area, they should seek medical attention. This is also a good idea when an injured area is numb or misshapen.
Medically Reviewed by Nayana Ambardekar, MD on April 24, 2021
If you’ve ever hurt your ankle or had another type of sprain or strain, chances are your doctor recommended rest, ice, compression, and elevation (RICE) as one of your first treatments. The RICE method is a simple self-care technique that helps reduce swelling, ease pain, and speed up healing. You can treat minor injuries with the RICE method at home. You might try it if you have an achy knee, ankle, or wrist after playing sports. If you have pain or swelling that gets worse or doesn’t go away, see a doctor. The RICE method includes the following four steps: Pain is your body’s signal that something is wrong. As soon as you’re hurt, stop your activity, and rest as much as possible for the first 2 days. Don’t try to follow the “no pain, no gain” philosophy. Doing so with certain injuries, like a moderate to severe ankle sprain, can make the damage worse and delay your recovery. Doctors say you should avoid putting weight on the injured area for 24 to 48 hours. Resting also helps prevent further bruising. Ice is a tried-and-true tool for reducing pain and swelling. Apply an ice pack (covered with a light, absorbent towel to help prevent frostbite) for 15-20 minutes every two to three hours during the first 24 to 48 hours after your injury. Don’t have an ice pack? A bag of frozen peas or corn will work just fine. This means wrapping the injured area to prevent swelling. Wrap the affected area with an elastic medical bandage (like an ACE bandage). You want it to be snug but not too tight -- if it’s too tight, it’ll interrupt blood flow. If the skin below the wrap turns blue or feels cold, numb, or tingly, loosen the bandage. If these symptoms don’t disappear right away, seek immediate medical help. This means raising the sore body part above the level of your heart. Doing so reduces pain, throbbing, and swelling. It’s not as tricky to do as you might think. For example, if you have an ankle sprain, you can prop your leg up on pillows while sitting on the sofa. The CDC recommends you keep the injured area raised whenever possible, even when you’re not icing it. Your doctor may suggest using nonsteroidal anti-inflammatory medications (like ibuprofen or naproxen) along with the RICE treatment. These are available over the counter and by prescription. Talk to your doctor about your health history before taking these medications.
Almost all of us, at some point, will strain or irritate a muscle or ligament. The resulting pain can have a big impact on your daily life.
To ease that pain, is it better to use ice or heat?
What is Inflammation?
Inflammation and pain is the body’s natural reaction to an injury. As much as it might hurt, swollen and inflamed tissue contains the components of healing that your body uses to repair itself after an injury.
When an area on your body is inflamed, fluid (“water on a joint”) and/or irritation cause pressure in the area. It’s this pressure that causes you to feel pain.
A good example is an ankle sprain. The ankle swells when it’s sprained because the body sends inflammation and increased fluid to the wounded area. Inflammation can also result from irritation in an area of the body’s tissue, such as a hangnail.
Depending on the nature and severity of the injury, in orthopedics, we treat inflammation using anti-inflammatory medication, elevation of injury, massage, cortisone injections, compression and rest.
Does heat make inflammation worse?
Ice (cryotherapy) beats heat (thermotherapy) for treating pain and inflammation in most circumstances. Although heat initially feels warm and cozy, ice helps decrease pain and inflammation in the long run.
DOWNLOAD OUR ICE VS. HEAT GUIDE
About Applying Ice
Ice constricts, or narrows, blood vessels. Constricting blood vessels inhibits the body from allowing inflammation in the iced area. Heat dilates, or widens blood vessels, allowing more inflammation to flow to an injured or painful area.
As a general rule of thumb, ice should be used if you have recently injured an area or had surgery or a procedure. Medical studies agree that 20 minutes of icing is most effective. You should ice with a cold compress or ice pack that is the temperature of a melting ice cube.
Some people have cold allergies, which cause ice to burn the skin. Put at least a thin towel between the ice and skin to avoid burned skin.
Greater than 20 minutes of icing can cause reactive vasodilation, or widening, of the vessels as the body tries to make sure the tissues get the blood supply they need. Studies have also shown 30 to 40 minutes in between icing sessions are needed to counter this reaction. The suggested time for icing is 20 minutes on and at least 30 minutes off.
Although many articles and studies may say that heat should be used for injuries and pain that have lingered for longer than six weeks, this is not necessarily the case.
For conditions such as chronic tendonitis and osteoarthritis, the body thinks that it can heal the worn or injured area. The body continues to go through a cycle of increased inflammation even though it cannot heal these conditions on its own.
Icing for 20 minutes several times a day can work as well as, if not better than, oral medications and injections. By controlling inflammation, symptoms often resolve or improve and pain subsides.
About Applying Heat
Heat does have its role. Heat works best in larger muscle groups. As an example, heat helps to ease back muscle spasms – as long as the spasms are not caused by a new fall or injury.
Moist heat or heat pads work best when used for 15 minutes on at a time and at least 30 minutes off.
Rules to Remember:
- If an injury has occurred to any body part within three days, ice is preferred -- 20 minutes on and 30 to 40 minutes off.
- Pain to the back, neck and large muscle groups like quads, hamstrings and calves will respond well to heat after three days of injury.
- Use ice for pain in joints such as knees, elbows and shoulders.
Keep It Local
Do not apply ice or heat to large areas of the body if only one joint or body part is the focus. As an example, a full-body ice bath should not be used to treat an ankle sprain.
The body cannot sustain the vasodilation, or decrease of blood flow, to such a large area. This type of treatment will not help the injured body part, so do not waste your time in a really cold bath.
Ice & Heat Together
As a more advanced treatment, use ice AND heat. To achieve therapeutic results, you must do this in a very specific way. The key is to ice for 20 minutes, causing the vessels to narrow, and then heat for 15 minutes, causing the vessels to dilate. This acts as a pumping mechanism to the inflammation, pushing it away from the injured area.
Most importantly, end the treatment cycle on ice (unless you’re treating a chronic back spasm). By ending on ice, the vessels will be narrowed and will help keep inflammation from re-entering the area.
Heat and ice can be used on all injuries or sore body parts at any time and can provide significant pain relief.
Ice is definitely not as comfortable as heat, and ice will sometimes ache or burn for the first five to seven minutes of the 20-minute session. If used appropriately, it can help tremendously with most aches and pains.
I always like to say, “An icing a day keeps the orthopedic doctor away.”
Kristi Wheeler, PA-C, is a Physician Assistant at the OrthoCarolina Hand Center.