RICE principle

The RICE principle is a simple and effective method in the early management of ligament sprains or muscle strains and contusions, which can be used as self-care technique and cannot be only prescribed by clinicians but also radiologists.

The RICE principle constitutes of the following measures :

Rest

An initial resting period serves as a measure to prevent further progression of the injury. For most ligamentous sprains, muscle strains or contusions it is applied for the first 24 to 48 hours after injury.

Ice

Ice or cryotherapy is applied to reduce pain and to decrease blood flow in order to prevent excessive interstitial fluid accumulation. Ice is usually applied intermittently for 15-20 minutes every 1-2 hours for at least several hours or a day. Ice packs should be wrapped within a light towel to prevent frostbite.

Compression

Compression aims also to reduce blood flow and to prevent swelling and excess interstitial fluid accumulation as well as to limit hematoma formation. Compression can be applied with elastic bandage wraps which should show a snug fit, but should not by any means be too tight since they can interrupt blood flow otherwise. Similar to ice compression can be applied in bouts.

In the case of numbness, tingling or bluish discolouration of the distal limb the wrap should be loosened.

Elevation

Elevation aims also at reducing pain and swelling as well as preventing excessive interstitial fluid accumulation and further hematoma formation by raising the injured limb above the level of the heart. This is usually also done for the first 24-48 hours.

This regimen can be further supplemented by non-steroidal anti-inflammatory drugs (NSAIDs) for pain control.