Do you put heat or cold on a injury from a fall?

Dear Ask The Doctor:  My sister age 48 slipped and fell on the ice and landed on her tailbone. Do we put heat or cold on it or do we alternate? She was able to get up and took a hot shower and ibuprofen.
 
Dear Patient:  After a coccyx trauma (fall), the first 48 hours local ice packs for periods of 15 minutes each time during the day are recommended, after the first 48 hours, local moist hot compresses are used for periods of 15 – 20 minutes each time, as many times during the day as needed. It is strongly recommended the use of anti-inflammatory drugs (i.e.: “Advil”, “Aleve”) to control pain and inflammation if not contraindicated by your doctor. Physical therapy, specifically, Myofascial release massage techniques on the area may be used. If after more than 3 months the pain persists, injection of anesthetic or corticosteroid may be considered

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