For an acute soft-tissue injury, initial management commonly involves RICE: rest, ice, compression, and elevation. Non-steroidal anti-inflammatory drugs (NSAIDs) may also reduce pain and inflammation, but they must be used appropriately and are not a substitute for assessment of a serious injury.
How RICE works
Inflammation produces pain, heat, redness, swelling, and reduced function. RICE aims to limit excessive swelling and pain during the early stage of injury.
| Intervention | Purpose and application |
|---|---|
| Rest | Protects the injured tissue from further damage. Rest should usually be relative rather than prolonged complete inactivity, followed by gradual, pain-free movement. |
| Ice | Causes temporary vasoconstriction and reduces pain. Apply a wrapped cold pack for about 15-20 minutes at a time; never place ice directly on the skin. |
| Compression | An elastic bandage limits swelling and supports the injured area. It must not be so tight that it restricts circulation or causes numbness. |
| Elevation | Raising the injured area above heart level assists venous return and helps reduce fluid accumulation. |
How NSAIDs work
NSAIDs, such as ibuprofen, inhibit cyclooxygenase enzymes, reducing the production of prostaglandins involved in pain and inflammation. They can therefore provide analgesic and anti-inflammatory effects.
However, NSAIDs can cause adverse effects, including gastrointestinal irritation, and may be unsuitable for people with certain medical conditions. Their use should follow the label or professional medical advice. Severe pain, deformity, loss of function, numbness, suspected fracture, or persistent symptoms requires medical assessment.
A common misconception is that RICE “heals” the damaged tissue. It mainly controls early symptoms; appropriate rehabilitation, including progressive loading, is needed to restore function.