RICE is a treatment method for soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation.[1][2][3] When used appropriately, recovery duration is usually shortened and discomfort minimized.
RICE is considered a first-aid treatment, rather than a cure for soft tissue injuries. The aim is to manage discomfort and internal bleeding.[4]
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Rest is a key part of repair. Without rest, continual strain is placed on the area, leading to increased inflammation, pain, and possible further injury. Also, most soft tissue injuries will take far longer to heal. There is also a risk of abnormal repair or chronic inflammation resulting from a failure to rest. In general, the rest should be until the patient is able to use the limb with the majority of function restored and pain essentially gone.
Ice is excellent at reducing the inflammatory response and the pain from heat generated. Proper usage of ice can reduce the destruction over-response which can result from inflammation. A good method is ice 20 minutes of each hour. Other recommendations are an alternation of ice and no-ice for 15–20 minutes each, for a 24–48 hour period.[5] To prevent localised ischemia or frostbite to the skin, it is recommended that the ice be placed within a towel before wrapping around the area.
Exceeding the recommended time for ice application may be detrimental, as blood flow will be too reduced to allow nutrient delivery and waste removal.
Compression aims to reduce the edematous swelling that results from the inflammatory process. Although some swelling is inevitable, too much swelling results in significant loss of function, excessive pain and eventual slowing of blood flow through vessel restriction.
An elastic bandage, rather than a firm plastic bandage (such as zinc-oxide tape) is required. Usage of a tight, non-elastic bandage will result in reduction of adequate blood flow, potentially causing ischemia. The fit should be snug so as to not move freely, but still allow expansion for when muscles contract and fill with blood.
Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will not only result in less edema, but also aid in waste product removal from the area.
Variations of the acronym are sometimes used, to emphasize additional steps that should be taken. These include:
As RICE and its variations work by reducing blood flow to the injured area, some people argue that for some types of injuries (such as ligaments and tendons) a protocol that increases blood flow, such as MEAT (Movement, Exercise, Analgesics and Treatments) should be used instead.[11]
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