RICE (medicine)

RICE is a mnemonic for a treatment method for soft tissue injuries which is an acronym for Rest, Ice, Compression and Elevation. When used appropriately, recovery duration is usually shortened and discomfort minimised.

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 component of repairing the body. Without rest, continual strain is placed on the affected area, leading to increased inflammation, pain, and possible further injury. Additionally, some soft tissue injuries will take longer to heal without rest. There is also a risk of abnormal repair or chronic inflammation resulting from a failure to rest. In general, the period of rest should be long enough that the patient is able to use the affected 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. 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 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 it has been shown to delay healing.

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, 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.

Compression stockings are a viable option to manage swelling with graded compression. These garments are especially effective post-operatively and are used in virtually all hospitals to manage acute or chronic swelling, such as congestive heart failure.

Elevation
Elevation aims to reduce swelling by increasing venous return of blood to the systemic circulation. This will result in less edema which reduces pain.

Variations
Variations of the acronym are sometimes used, to emphasize additional steps that should be taken. These include:


 * "HI-RICE" - Hydration, Ibuprofen, 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, Compression, and Elevation
 * "RICER" - Rest, Ice, Compression, Elevation, and Referral
 * "DRICE" - Diagnosis, Rest, Ice, Compression, and Elevation
 * "POLICE" - Protection, Optimal Loading, Ice, Compression, and 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.