Paying the PRICE
P rotect the injured part from further injury. The site of the injury will determine how best to protect it.
R est the affected joint or muscle for 48-72 hours following injury. For example, consider the use of crutches for an ankle, knee or leg injury.
I ce - the cold from the ice is thought to reduce blood flow to the damaged ligament or muscle. This may limit pain and inflammation.
Ice should be applied as soon as possible after injury. Wrap the ice in a damp towel and apply it to the injured area for 15-20 minutes. A bag of frozen peas is an alternative. Gently press the ice pack on to the injured part. This should be done every 2-3 hours during the day, for the first 2-3 days after the injury. (Do not put ice directly next to skin, as it may cause ice burn. Also, do not leave ice on while asleep, and do not apply it for more than 30 minutes, or it may damage the skin.)
C ompression with a bandage will limit swelling, and help to rest a joint. A tubular elastic bandage or a simple elasticated bandage is suitable for most joints. A pharmacist will advise on the correct type and size.The bandage should feel snug, but not uncomfortable or tight, and should not stop blood flow. Remove before going to sleep. You may be advised to remove the bandage for good after 48 hours, so that the joint can move. However, sometimes it is advisable to kept the bandage on for longer, to help lessen the swelling and to keep the joint more comfortable.
E levation aims to limit and reduce any swelling. For ankle and knee sprains, keep the foot up on a chair to at least hip level when you are sitting. (It may be easier to lie on a sofa and to put your foot on some cushions.) When you are in bed, put your foot on a pillow. For hand or wrist sprains, use a sling with your hand and wrist higher than your elbow.
Avoid HARM for 72 hours after injury. That is, avoid:
H eat - for example, hot baths, saunas, heat packs. Heat has the opposite effect on the blood flow to ice. That is, it encourages blood flow. So, heat should be avoided when inflammation is developing. However, after about 72 hours, no further inflammation is likely to develop and heat can then be soothing.
A lcohol drinks which can increase bleeding and swelling and decrease healing.
R unning or any other form of exercise which may cause further damage.
M assage which may increase bleeding and swelling. However, as with heat, after about 72 hours, gentle massage may be soothing.
Other treatments
Your doctor, nurse or physiotherapist will advise. The advice may include:
For sprains Do not stop moving the affected joint. Dont do anything that causes much pain, but gently get the joint moving again. Sometimes it means doing gentle exercises several times a day. The aim is to get the joint moving in all normal directions, and to prevent it becoming stiff. Physiotherapy may help for more severe sprains, or if symptoms are not settling. A physiotherapist can advise on exercises and may give heat, ultrasound, or other treatments. However, you should not play sport or do vigorous exercise involving the injured joint for at least 3-4 weeks after the injury.
For strains It is best to immobilise the injured muscle for the first few days after the injury. You may be advised to use crutches in severe injuries. After a few days you can usually gradually start to use the muscle again. Again, this may be under the supervision of a physiotherapist or other health professional.
Severe sprains and strains
If the ligaments or muscles are badly torn, further treatment may be needed. Sometimes a brace or cast is used, to support the torn area while it heals. For example, a brace may be used for severe ankle sprains.
Torn ligaments sometimes require surgery to repair them. Your doctor will assess if this is necessary (but it is not needed in most cases).
For badly torn muscles, surgery is used very rarely - usually only if there is a complete tear in which the muscle is retracted (pulled back). Muscles are less easy to repair surgically than ligaments, because the muscle fibres do not hold stitches easily.
According to patient