The Best Way to Chase Pain

Q: Whether to use ice or heat for pain relief for an injury always confuses me. What works best?
-- Anonymous

A: Here's one way to remember what to do when you first hurt yourself: Ice is nice, hot is not. That's true for the first 2 to 3 days, while your system is responding to the injury. Holding an ice pack to the area (we like to use a bag of frozen peas; they mold to the spot) for 15 to 30 minutes at a time reduces pain and can prevent swelling when you also elevate the injured body part and apply pressure to it. (Remember it by the acronym RICE: rest, ice, compression, and elevation.) Heat is not your friend at first because it increases circulation, which puts painful pressure on nerve endings. The warmth stimulates the flow of inflammatory chemicals, too, which makes pain worse. Save the heating pad for 48 to 72 hours after the injury -- that's when you want to boost blood flow to ferry away waste and debris, enhance delivery of nutrients and oxygen to speed healing, and raise the pain threshold in nerves. Warmth also relieves stiffness, helping you move more freely, and that further increases the healing blood flow.

Q: Is it true that having a tubal ligation can cause heavy bleeding or bleeding between periods? I've heard these are part of what people are calling "post tubal ligation syndrome."
-- Anonymous

A: It's doubtful that tubal ligation is the problem. Researchers studying data from more than 10,000 women found that those who had undergone this procedure were no more likely than other women to have menstrual problems. That doesn't mean that some women don't have heavy bleeding or bleeding between periods after tubals. It's just that the tubal may not be the cause. Instead, it may be that women who opt for having their tubes tied have recently stopped taking birth control pills or have just had a baby -- and both can cause heavy bleeding.

Other issues attributed to the syndrome include menopause-like symptoms of mood swings, depression, hot flashes, and insomnia. But since tubal ligation doesn't affect your ovaries -- the major source of your female hormones -- the procedure isn't a likely reason for those symptoms, either. That said, if the symptoms bother you, go to your gynecologist; he or she may be able to help you get rid of them, no matter what the cause.

Q: Why do I get a crazy itch around my tummy and thighs when I jog?
-- Anonymous

A: It's possible that your workout clothes are to blame for your "itchy pants syndrome." We don't know whether the synthetic material or some finishing chemical stimulates a reaction in sensitive people, but wearing 100% cotton gear and washing it before you put it on for the first time helps many -- including pro basketball players -- stop scratching.

Another possibility is that you may be triggering an allergy you didn't know you had. As you heat up, your body can react to a food that normally doesn't bother you. (Some people get a similar reaction when they get warm in a sauna or hot tub. Allergists report exercise-induced reactions to seafood, celery, wheat, and cheese. You might also be reacting to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) if you took those beforehand.

Taking an antihistamine before exercising should stop the itch, but you may not feel much like running if those drugs make you sleepy. If you develop hives that don't go away within 10 minutes of stopping exercise or if you notice other symptoms, like stomach cramping; swelling of your face, tongue, or hands; headache; or a choking sensation, call your doctor immediately. Life-threatening allergic reactions to exercise are rare but can actually happen. If changing clothes or your diet doesn't tame the itch, see an expert, since exercise is important to a long and high-quality life.