RICE (medicine)
Encyclopedia
RICE is a treatment method for soft tissue injury
Soft tissue injury
A Soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one off blow resulting in a contusion or overuse of a particular part of the body...

 which is an acronym for Rest
Rest
Rest may refer to:* Leisure* Human relaxation* SleepRest may also refer to:* Rest , a pause in a piece of music* Rest , the relation between two observers* Rest , a 2008 album by Gregor Samsa...

, Ice
Ice
Ice is water frozen into the solid state. Usually ice is the phase known as ice Ih, which is the most abundant of the varying solid phases on the Earth's surface. It can appear transparent or opaque bluish-white color, depending on the presence of impurities or air inclusions...

, Compression and Elevation
Elevation (kinesiology)
Elevation, in kinesiology is the anatomical term of motion for movement in a superior direction.It is the opposite of depression.-Muscles:* elevation of the scapula at the shoulders Elevation, in kinesiology is the anatomical term of motion for movement in a superior direction.It is the opposite of...

. 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.

Rest

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

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. To prevent localised ischemia
Ischemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...

 or frostbite
Frostbite
Frostbite is the medical condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas...

 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

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
Elastic bandage
An elastic bandage is a "stretchable bandage used to create localized pressure". Elastic bandages are commonly used to treat muscle sprains and strains by reducing the flow of blood to a particular area by the application of even stable pressure which can restrict swelling at the place of injury...

, 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
Ischemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...

. The fit should be snug so as to not move freely, but still allow expansion for when muscles contract and fill with blood.

Elevation

Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will not only result in less edema
Edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

, but also aid in waste product removal from the area.

Variations

Variations of the acronym are sometimes used, to emphasize additional steps that should be taken. These include:
  • "HI-RICE" - Hydration, Ibuprofen
    Ibuprofen
    Ibuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....

    , Rest, Ice, Compression and Elevation
  • "PRICE" - Protection, Rest, Ice, Compression and Elevation
  • "PRICE" - Pulse (Typically Radial or Distal), Rest, Ice, Compression, and Elevation
  • "PRICES" - Protection, Rest, Ice, Compression, Elevation and Support
  • "PRINCE" - Protection, Rest, Ice, NSAIDs
    Non-steroidal anti-inflammatory drug
    Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, but also referred to as nonsteroidal anti-inflammatory agents/analgesics or nonsteroidal Anti-inflammatory medicines , are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory...

    , Compression, and Elevation
  • "RICER" - Rest, Ice, Compression, Elevation, Referral
  • "DRICE" - Diagnosis, Rest, Ice, Compression, Elevation

Alternatives

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.
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