Elevation refers to raising the damaged area as high as is possible to reduce hydrostatic pressure. Massage and heat have a part to play in some soft tissue injuries. Heat stimulates the A fibres as described above. It also helps restore the elastic properties of collagen which gets stretched in sprains and strains. However, if applied during the early stages of the condition, it increases blood supply and hence may increase release of adverse chemical mediators.
Massage acts as a counterirritant.
Again, this should not be applied too soon after the injury but light rubbing seems to initiate pain relief by the gate theory mechanism. Product selection Drug therapy for sprains and strains can be systemic or topical. Neither require comment in this section as they are well documented elsewhere. Their mode of action is not clearly established, but one theory has already been discussed. P from the sensory nerve endings.