Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright May 13, 1987     

The moment you’ve all been waiting for has arrived. Today is the day I give the answers to the First annual Liberal Hot-Cold Quiz. Last week I gave 10 situations where the indication was to apply heat or cold to a person with pain. A few weeks ago I discussed the reasons why one would use one as opposed to the other.

The quiz was easy. The answers appear below and I must give one ‘but’ first. Different doctors have been trained differently, and their rationale for using heat or ice might be different from mine. Just remember that I am right and they are wrong-no, no just kidding.

The following answers are my own opinion and would also be the opinion of most doctors, chiropractors and physiotherapists. Some experts may feel differently for various reasons, and of course the variables in each case are different, but as far as the First annual Liberal Hot cold Quiz is concerned, these are the answers.

1)      Use ice on the young soccer player’s knee sprain to shrink the blood vessels and decrease swelling and pain.

2)      Use moist heat on your mother’s hands to increase the local blood flow, reduce spasm, and to give her a relaxed feeling of ‘warmth.’

3)      Because the headache is pounding, one may assume that ice placed strategically will shrink the blood vessels and stop the pounding. This is similar to what caffeine-based medication does for some migraine headaches.

4)      Skinny, hairless, dry legs require heat to increase the blood flow to the legs, and therefore a hot bath would probably feel good.

5)      If the child has a stomach ache after running around after dinner it is likely that the blood which should be used to promote proper digestion is being diverted to the extremities for activity. Therefore, a hot cloth over the child’s stomach, and even rubbing the stomach a bit, will enhance digestion and decrease the pain.

6)      This is an easy one. If you feel tight, tired and sore after a long day at work, take a hot shower. This one was a gift question.

7)      A scraped knee will respond nicely to a cold cloth or an ice pack which will shrink or close-off the torn capillaries.

8)      Always use heat before the baseball game to ‘loosen’ your muscles.

9)      Always use cold after your baseball game to decrease irritation of the muscular tendons.

10)  I had to throw one difficult question in. This guy has had a back pain for a few days. It is just now getting severe, and he is feeling pain down his leg. If this was my patient I would tell him to apply moist hot packs to his lower back to reduce the pain and spasm in his muscles. I would also say to apply ice packs to his lower back to decrease the inflammation in the nerve (which is what is causing the pain down the leg).

Therefore, as you can see, the use of ice does not preclude the use of heat and vice versa. Sometimes the use of both is advantageous. This man should apply moist hot packs for about 15 minutes and then follow immediately with an ice pack for the same length of time. He should then wait about half an hour before repeating the same cycle again. This has a ‘pumping’ action on the blood vessels, and although the physiology is difficult to understand, trust me, it works!

Well, how did you score? If you scored perfect you should wander the streets with a hot pack in one hand and an ice pack in the other, ready to use your expertise to help those in need. If you scored 5 to 9 you should hit the library right away to prepare for next year’s quiz. Anything less than 5 and you should go to the Liberal offices and ask for a copy of my April 22 column.