means to reduce swelling

[geri42]

hi everyone,
in your experience what is the best way of treating a chronic or sub acute swelling ?
i'm interested to hear also all sorts of traditional or "bizarre" means to reduce a swelling - probaly told by a patient.....please write the only one's which you are sure that made a change and really helped.

[estherderu]

dear geri42

one of the first things you do when you bump yourself is rub. But you mostly stop after a few rubs. Rubbing an acute swelling can really help diminish it if you do so for at least a few minutes. You will feel the swelling slowly disappear under your hands.

Try it, when you bump your head... it really works, I have also had success with ankle swelling after a distorsion.....

Read this somewhere once upon a time. Tried it and tell others about it. What the scientific background is, I do not know I´m afraid...

esther

[msk101]

Hi,
I'm curious as to why you're asking (are you planning on trying on yourself or a client? are you researching ideas? etc.??

I think it's important to understand the reason for swelling being present in the first place ... eg. is there fluid because of cardiac overload... will you risk increasing kidney load or cardiac load by pushing extracellular fluids back into the central blood volume? or is it just a musculoskeletal injury that's not been managed early enough and has residual swelling and thickenings?

For the latter, I am a fan of contrast baths to stimulate the dilation/contraction of peripheral blood vessels to move old or thickened oedema. This works really well for icky ankles and wrists. not so good for proximal issues. eg. for an ankle. Get 2 large tubs (big enough to put foot flat into the bottom of). Fill one with warm (but not super hot) water, the other has iced water. put the offending foot/ankle (up to about mid-shin) in the ice for 30sec, then warm water 30sec. do this 3 times each then finish with 45-60 seconds in the ice. This is NOT FUN to do but works quite well. This often then allows more freedom of movement at the joint so you can do your mobilisations, gait training or management to prevent the swelling returning. This can be done daily or more often depending on your clinical decisions regarding the swelling.

For any oedema that you are concerned is not a local musculoskeletal issue, make sure your client is cleared by a doctor, is on appropriate medications (ie. diuretics) etc before you jump in to "treat" the fluid at a local level.

Cheers,
msk101

[geri42]

hi msk101,
thank you for your clever and wise advices. i'm interested in this issue for two reasons: first i want to try to apply this on myself (i sprained my ankle a month ago ),and second on my patients in the clinic. .
since iv'e sprained my ankle i heard a lot of different sometimes odd and sometimes funny advices from common people about how to treat the swelling, and i'm
curious**in what other p.t.'s have in mind according to their experience

[Rinkusabharwal]

hello every one i think if the swelling is acute the cryotherapy is the best treatment

[alophysio]

Hi,

i did have a patient once tell me about leaving lemons in a bucket of water to rot and then using the liquid to "paint" onto his ankle - he felt it helped. I was wondering if it might be similar to acetic acid iontophoresis??

[Dr.Kinjal]

hiiiiiiiii

after knowing the exact reason for the swelling....... i think you can try LASER THERAPY... according to my expe...it really works good along with cryotherapy...

[alophysio]

hi...i am interested, what is the EXACT reason for the swelling??

[jonathan_PTRP]

3 Simple ways to reduce swelling:
- Massage
- Compression
- Elevation

[geri42]

dear alophysio,
with regarad to your question:i have a "common" swelling, the type that appears after twisting a joint and the relative ligaments, but i aimed my post to all different kinds of swellings...thx for your post it certainly had the kind of traditional knowledge i am looking for...
geri

[alophysio]

Cool - i normally just ask them to ice bucket like the contrast bath above - 10mins in, 10 mins out, 10mins in every 2 hours. If you do that in the acute stage, things are a lot easier after...

[Canuck Physio]

Originally Posted by alophysio

Cool - i normally just ask them to ice bucket like the contrast bath above - 10mins in, 10 mins out, 10mins in every 2 hours. If you do that in the acute stage, things are a lot easier after...

- does laser therapy even work?

[estherderu]

dear everyone,

I have been in the profession for a while now and during my education (35yrs ago) we were taught to use the so called cold/icy-hot water baths. The problem was, nobody really knew for how long. Some people said, 8-10 seconds per bath, the others 30 sec´s etc.with no scientific backing at all at that time. In the above replies, we also see different time schedules!

I changed this by deciding to ask the patient for their opinion.... and lo and behold that was a good idea.
my "protocol" became....( especially for sprained ankles- after acute phase)

First find out what your patient really likes and dislikes first (warm-cold)
1. if they hate cold, start with warm....and if they hate warm, start with cold...
2. in the first case ( hate cold) start with warm untill their foot starts to feel nice and warm....
2. put foot in cold water untill they feel their foot feels really cold....
3 change back and forth and stop with a short cold session.

I have never looked into the scientific background for this protocol I must say.Most probably because it is no more that a measure you tell the patient to do at home. In my opinion it is not physiotherapy.

This bath routine can be done at home and because it is not unpleasant, I have the experience that people will do so.


Esther de Ru

[alophysio]

Good points esther.

My 10mins in, 10mins out, 10mins in is adapted from research which showed that ice pack on ankle sprain for 10mins on/10 off/10 on again every 2 hours was better than 20mins on straight every 2 hours. Don't have the reference with me here at home i am afraid.

Thanks again - good point about research!