Hot or Cold: The Degree to Which Pain is Treated

At some point in our lives, we have all probably been instructed to apply hot or cold to our wounds. Have you ever wondered why one temperature is often preferable to use over another?

The answer is simple: you can generally use heat for muscle pain or stiffness, and cold for acute injuries and pain, along with inflammation and swelling. For a more in-depth response, continue reading.

When Should I Use heat?

Heat boosts the flow of blood and nutrients to an area of the body. It often works best for morning stiffness or to warm up muscles before activity. By increasing the temperature to a particular area, heat therapy works to improve circulation and blood flow. Even just a slight increase in temperature to the afflicted area can soothe discomfort and increase muscle flexibility. Heat therapy helps loosen tense muscles, which contributes to pain relief. It also increases blood flow to an injury, which can help promote healing.

One of heat therapy’s biggest benefits is that you can use it for an extended period of time when applied indirectly to the skin, unlike cold therapy, which has no indirect method of application, and needs to be limited in exposure. The direct-contact use of high temperatures is not recommended for a long period of time, but because heat can also be applied indirectly, heat therapy via things such as a sauna or a hot bath can be utilized for a much longer period. Where minor stiffness or tension can often be relieved with only 15 to 20 minutes of heat therapy, moderate to severe pain can benefit from longer sessions like a warm bath, lasting between 30 minutes and two hours.

Sources of heat can be things such as a heating pad or a warm bath. Other sources include: dry/moist heating packs, saunas, and steamed towels.

Risks and Limitations of Heat Therapy

In regards to heat therapy, there are multiple cases in which it should not be used. Those with any preexisting conditions such as: diabetes, vascular diseases, dermatitis, multiple sclerosis (MS), and deep vein thrombosis should avoid the use of heat therapy due to an increased chance of complications and burns. Those with heart disease or hypertension should consult their doctor before use. Those who are pregnant should also consult their doctor, specifically before using a hot tub or sauna.

Heat therapy should not be applied to any area with an open wound, nor should it be applied if the area is either swollen or bruised (or both).

Heat therapy runs the risk of burning the skin if you use heat that’s too hot. With heat, you also run the risk of supporting the spread of an infection, as the increased blood flow that comes with higher temperatures will support the infection’s biological processes and growth. If you’re applying heat directly to the skin through something such as a heating pad, you should do so for no more than 20 minutes at a time.

When Should I Use Cold?

Cold therapy is also known as cryotherapy. Cold can numb pain by causing blood vessels to constrict and reducing blood flow to a particular area, which helps reduce swelling and inflammation. It can temporarily reduce nerve activity, which can also relieve pain.

Sources of cold can include: ice packs, bags of frozen vegetables, frozen gel packs, ice baths, coolant sprays, and ice massages.

Risks and Limitations of Cold Therapy

Cold therapy should never be applied directly to the skin, as it can cause damage to the skin and tissues. Use cold therapy only for short periods of time, several times throughout the day. Ten to 15 minutes is fine, but no more than 20 minutes of cold therapy should be used at once. If you’re not careful, cold therapy applied for too long or too directly can result in nerve, tissue, or skin damage via ice burns. Those with sensory disorders, including diabetes, that prevent them from feeling certain sensations should not use cold therapy without supervision because they may not be able to feel if damage is being done.

Cold therapy should not be used on stiff muscles or joints. It should also not be used if you have poor circulation. If you have cardiovascular or heart disease, please consult your doctor before using cold therapy.

Hot or Cold: In Summary

The tricky part is knowing if a situation calls for heat or cold. You may find that either will provide relief, and sometimes a single treatment will even include both, alternating between the two. For example, those with arthritis may use heat for joint stiffness and cold for swelling and acute pain.

Unfortunately, the application of heat or cold often won’t completely resolve your pain. It may help lessen its severity and reduce inflammation, but in most cases, use of a heating pad or ice pack is applied in tandem with other pain treatments.

If the use of hot or cold aggravates your pain or discomfort, stop it immediately. If you notice an increase in inflammation after use, or if the treatment hasn’t helped much with regular use after a couple days, you should make an appointment to see our doctors at Healthpointe to discuss other treatment options.