Physiatry: Ice Massage

It is axiomatic in medicine that if many different treatments for a single condition are listed in the textbooks, none of them can be much good. Dozens are listed for the pain and disability in muscles and joints that commonly result from everyday injuries. They include drugs, heat, cold, rest, exercise, etc. Lieut. Colonel Arthur E. Grant, chief of physical medicine at Brooke Army General Hospital in Texas, was aware of all the possibilities because he was responsible for thousands of G.I.s who kept getting themselves banged up. He wanted something more effective than traditional medicine.

Dr. Grant had noted, as has many another TV sports fan, that athletic trainers seem to get good results with a cooling ethyl chloride spray. And he knew about applying hot-water bottles filled with ice cubes. But if a little cold is good, Dr. Grant reasoned, deeper chilling might somehow ease the pain and help the accident patient get his muscles and joints working sooner. Dr. Grant was certain of one thing at least: the longer a muscle or joint is immobilized by pain, the harder it is to get it working again.

Dr. Grant’s team of physiatrists hit upon ice massage as the way to induce a deep chill. As they developed their technique, the medics began to use half-pound chunks of ice, frozen in cans, held in a washcloth. Patients complained of an uncomfortable chill, then of a burning sensation, then of an ache, but finally they reported a blessed numbness and easing of pain. If the injury was in a part of an arm or leg that could be dipped in water, it was dunked, then ice cubes were dropped into the water until the cycle of discomfort ended in numbness.

Among the first 1,000 patients—young G.I.s with fresh injuries—the deeper-chill method was successful in about 90% of the cases. Dr. Grant extended the method to 7,000 soldiers and ex-soldiers of all ages, and their wives, now reports that it has worked well in more than 75% of such patients.

Ice massage, Dr. Grant points out, should not be tried in such joint disorders as rheumatoid arthritis, which are known to be eased by heat and aggravated by cold. But for routine strains, sprains, bruises and Charley horses, he finds chilling to the point of numbness the most effective treatment yet devised. And even though patients may complain at first of its discomfort, they usually feel so much better after the treatment that they go home and do it for themselves.