Cold may be applied in a variety of ways, including:

• Ice. Ice should not be applied directly to the skin. A protective barrier, such as a towel, should be used.
  
  
• Ice packs. Devices that store ice and can be kept cold in the freezer are available in drug stores and other shops.
  
  
• Chemical cold packs. These are available in stores and are often found in first aid kits. They are warm to the touch. When pressure is applied, the pack turns cold.
  
  
• Vapocoolant spray. These sprays often contain fluoromethane or ethyl chloride and are used to treat pain from muscle spasms.
  
  
• Cold baths. Soaking in very cold water can have the same effect as using other devices. Patients are advised not to soak for no longer than 20 minutes.
  
  
• Ice massage. Ice can be used to numb tissue before massage therapy, which is a type of manipulation therapy. Ice massage can deliver cold more efficiently to an area than cold packs or other means of applying cold.

Cold generally may be applied for 10 to 20 minutes and then removed. Cold sources should be sealed to avoid dripping, flexible so they conform to body parts and wrapped to prevent skin irritation.

With acute injuries, cold therapy is often used in conjunction with a first aid technique called RICE (rest, ice, compression and elevation). This technique involves:

• Resting the injured body part.
  
  
• Applying ice for intervals up to two days to reduce or prevent swelling.
  
  
• Wearing an elastic compression bandage for up to two days to reduce or prevent swelling.
  
  
• Keeping the injured body part elevated above the heart to reduce or prevent swelling.