Musculoskeletal sprains and strains

Advise patients to use rest, ice, compression, and elevation (RICE) as soon as possible.

The affected part should be stabilised, protected, and rested for up to 48 hours after injury, depending on pain.

The affected part should be immersed in ice water for up to 10 minutes, or a malleable ice pack (e.g., bag of frozen peas) should be applied for 10 to 30 minutes. Cold injury should be avoided, and the affected part should be allowed to warm up before the procedure is repeated, which may be as frequently as desired for 48 hours: for example, every 2 hours while the patient is awake.

Compression should be applied with care to avoid constricting blood flow. If tissues distal to the compression become blue or painful, the compression should be loosened and re-applied with less tension. If peripheral arterial disease is present or suspected (e.g., in older people or people with diabetes), compression should be used with caution.

If practical, the injured part should be elevated above the level of the heart.

Avoiding rapid return to work is advised. Patients should undergo proper rehabilitation. Duration of rehabilitation is determined by the severity of injury. Online information from recommended websites may be helpful. NHS Choices: sprains and strains Opens in new window