RICE Method Benefits and Side Effects

Ask a doctor, nurse, paramedic, or athletic trainer what to do for a soft-tissue injury like a sprain or strain and you're likely to hear the same advice: a treatment regimen known as RICE.

The RICE acronym stands for:

• Rest
• Ice
• Compression
• Elevation

For decades, RICE has been the gold standard for minor sprains and strains. But does this method work?

This article will look at the RICE process, the pros and cons of this method, and what else you can do for mild soft-tissue injuries.

Process

Those who recommend RICE say to start it as soon as possible after you're injured. The steps are:

• Rest: Stop activity as much as possible. Don't use the injured body part and protect it from further damage.
• Ice: Apply an ice pack to reduce pain and swelling for between 10 and 20 minutes at a time, a few times a day. Do this for the first two to three days. Protect your skin with a towel or other cloth.
• Compression: Wrap the injured area with an elastic bandage (like an Ace bandage). Loosen the bandage if you notice numbness, tingling, increased pain, or swelling below the wrap.
• Elevation: Raise the injured part to or above heart level anytime you're sitting or lying down.

Once the swelling goes down, RICE proponents say to switch to heat instead of ice. If you need a wrap for more than three days, see a healthcare provider. You may have a serious injury.

This method is touted so often that you might think there's a lot of evidence supporting its use. There's not. Rather, this method caught on despite a lack of research.

Pros

The primary goals of RICE are to relieve pain and inflammation and help the injury heal. RICE does, in fact, reduce pain and inflammation.

• Resting the part means you're not causing more pain.
• Ice numbs the area.
• Compression and elevation keep swelling down, which also helps manage pain.

When it comes to healing, though, some experts now question this conventional wisdom.

Cons

The evidence for using RICE—especially the ice part—is sketchy at best. The major flaw lies in restricted blood flow.

When you're injured, your body rushes more blood to the area as part of the healing process. RICE can prevent that.

Reducing Blood Flow

Blood flow is necessary for healing. Our bodies have to break down damaged cells and rebuild them using raw materials. Without proper blood flow, the whole process can take longer.

Healing requires controlled, not restricted, blood flow. That allows the body to heal much more efficiently.

When you use RICE, each step can limit blood flow.

• Movement encourages blood flow. Keeping the part immobile restricts the flow.
• Where you apply ice, blood vessels constrict to protect your body from cold.
• Compression mechanically limits blood flow—compressed blood vessels can't bring more blood to the area.
• Elevation, by way of gravity, makes it hard for your body to get adequate blood to the injury.

The problem is that RICE does work well to prevent inflammation and swelling. But those are a result of the rush of blood to the area, and you need that to happen.

By not interfering with the flow of blood, you might see faster healing. You may have more discomfort, but if you recover faster, it may be a worthwhile sacrifice.

Joint Stiffness

Rest is also questioned for other reasons. Evidence suggests that appropriate movement is better than complete rest when it comes to healing.

Inactivity leads to stiffness and tissue atrophy (wasting). That can drag out the healing process as you'll need to build back your muscle tone and strength.

Meanwhile, movement not only improves blood flow, but it also releases chemicals called growth factors. Those maintain, repair, and strengthen your tissues.

Ice Burn

If you ice too much or place a cold pack directly on your skin, it can cause an ice burn (frostbite).

The first sign of damage is your skin turning red or pale, then feeling tingly or prickly. That's a sign you should stop icing and allow the skin to warm up.

When you ice an injury, be certain you have a towel or other cloth layer between you and the pack. Don't ice for more than 20 minutes at a time. And let your tissues fully warm up before applying it again.

What To Do Instead

So far, no one has come up with a handy acronym to replace RICE. Some have been suggested, including:

• MICE (replacing rest with movement)
• METH (movement, elevation, traction, heat)
• MOVE (movement, options for rehabilitation and training, varied exercise, ease back into activity early)

All of these are problematic, though. MICE continues to use ice and compression so it has become outdated.

METH and MOVE are more for healthcare practitioners than for you taking care of your injury at home. Traction, which is gently pulling on the injured area, should only be done by a physical therapist or other trained professional.

Also, MOVE only focuses on rehabbing an injury, not pain control. So you may also want to borrow the E (elevation) and H (heat) from METH to help alleviate your pain.

What you're left with when it comes to self-treatment is movement, elevation, and heat.

Movement

Early movement may include gentle stretching and movements to keep the area from stiffening up. If it's a lower-body injury, you may want to put some weight on it.

Your healthcare team can advise you about what's appropriate at each stage of healing.

Elevation

Current wisdom still supports elevating the injury when you're resting. For example, put your sprained ankle on a chair instead of letting it rest on the ground. You don't have to keep it elevated as often as recommended by RICE, though.

Moderate elevation can keep the area from swelling more than necessary but won't limit the blood flow too much.

Heat

Heat feels good on sore soft tissues and encourages blood flow. It may also encourage inflammation. So it's not the best option if your injury is pretty puffed up and sore.

If you're not sure whether you should use heat, talk to your healthcare provider about it.

As with ice, don't overdo it. Apply heat for no longer than 30 minutes at a time. Use moderate heat and don't burn yourself.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are a mainstay of pain and injury treatment. Remember, though, that some inflammation is good. Don't over-use them.

Over-the-counter NSAIDs include:

• Advil/Motrin (ibuprofen)
• Aleve (naproxen)
• Aspirin (acetylsalicylic acid)

If you continue having a lot of inflammation despite taking these medications, talk to your provider. They may give you a stronger prescription NSAID or corticosteroids to combat inflammation.

For pain management beyond what NSAIDs offer, Tylenol (acetaminophen) may be a good option. For severe pain, ask your provider about other possible medications.

When to Talk to Your Doctor

Some soft-tissue injuries can be treated at home. Others require a healthcare provider's care.

Get medical attention if:

• You've treated an injury at home for several days but it's not improving
• You can't move it
• You can't put weight on it
• It's significantly swollen
• Pain is severe and doesn't go away with rest
• A bone looks misaligned
• The area turns blue
• The injury site is numb
• There's bleeding or broken skin

If you're not sure about the severity of your injury, get it looked at just to be sure you're treating it properly.

Summary

The traditional RICE method for treating soft tissue injuries limits blood flow to the injury. That might slow down the healing process.

Evidence suggests that movement and heat may be better for healing than rest and ice. Elevation can help keep swelling under control, and medication can help with pain while the injury heals.

A Word From Verywell

You can find a lot of websites, coaches, and healthcare providers who still recommend RICE. That advice has been around for a long time and some people continue to swear by it.

You may want to discuss the problems of RICE with your provider and look at other treatment options for pain and rehabilitation.