Hot or Cold?

Using Hot and Cold for Pain Relief

Both heat and cold can help reduce pain, but deciding which one to use, and when, can be confusing. These basic rules may help:

Use cold for acute pain or a new swollen/inflamed injury. ‘Acute’ pain comes from a sudden injury (i.e. spraining your ankle). Common symptoms of an acute injury are pain, swelling, redness or heat, which generally come on within the first few days after an injury.

Use heat for chronic pain or an ‘old’ injury.  ‘Chronic’ pain develops over time, and may come and go.  Chronic pain is often a result of overuse of the body part and may follow an acute injury that hasn’t been treated properly, or that hasn’t healed within the usual timeframes.

Ultimately, you need to choose what works best for you. If icing feels unpleasant, then heat may provide more comfort. It is important to take the type of injury into account as different types of injuries need different treatments to heal properly.  It is also important to take care of the skin when using both hot and cold, particularly for the elderly or those with skin conditions. Ice and heat are not substitutes for medical evaluation and treatment.

Heat for Pain Relief

Heat is relaxing. That’s why overworked muscles respond to heat. Heat stimulates blood flow, assists in the elimination of toxins, relaxes spasms, and soothes sore muscles.

How It Works
When muscles are overworked or circulation is compromised, they can become congested and lead to a painful muscle ache. Applying heat to an area causes vasodilation, or a widening of the blood vessels, which increases blood flow and helps in the exchange of nutrients in an area.

Often after a period of exercise, you can develop symptoms of muscle soreness. This type of pain is often called ‘delayed onset muscle soreness’, or DOMS for short, and is thought to be due to micro-trauma to muscle fibres.  Heat can help to restore blood flow and speed muscle recovery.

When to Use Heat Therapy
Heat is best for chronic pain. Chronic pain is persistent or recurrent pain.

If you suffer from an ongoing injury, apply heat before exercising. Applying heat after exercise can aggravate existing pain.

Sometimes in the presence of chronic pain, you may have an acute inflammation at the site after over-activity. In this case, you could use ice on the site for a few days, as described above.

Types of Heat Therapy
Localized heat is applied to a specific area with a:

  • hot water bottle
  • heating pad
  • moist heat (hot, damp towel)
  • wheat bag

Systemic heat raises your body temperature with a:

  • hot bath
  • sauna
  • steam bath
  • hot shower

Tips for Applying Heat

  • Protect yourself from direct contact with heating devices.
  • Wrap heat sources within a folded towel to prevent burns.
  • Stay hydrated during systemic heat therapy.
  • Avoid prolonged exposure to systemic heat therapy.
  • Apply wheat bag or hot water bottle for 15-20 minutes, keeping skin protected with a towel.

Hot or Cold


Cold for Pain Relief

Generally, ice is used to help recent injuries. When your body is injured, the damaged tissue becomes inflamed.  This can cause pain, swelling, or redness.  Swelling is your body’s natural response to injury.  Unfortunately, local swelling tends to compress nearby tissue which leads to pain.

How it Works
Studies show that icing an area causes vasoconstriction, or narrowing of the blood vessels, which slows down blood flow to the affected area. This helps in controlling the amount of inflammation and swelling that occurs at the injury site. It relieves pain, but does not treat the underlying cause.

When to Use Cold Therapy
Cold is best for acute pain caused by recent tissue damage (acute inflammation). Ice is used when the injury is recent, red, inflamed, or sensitive.

Cold therapy can also help relieve any inflammation or pain that occurs after exercise; this is a form of acute inflammation. However, unlike heat, you should apply ice after going for a run. Cold treatment can reduce post-exercise inflammation.

Types of Cold Therapy
Cold should only be applied locally. It should never be used for more than 20 minutes at a time and never be applied directly to the skin. You can apply cold using:

  • an ice pack
  • an ice towel—a damp towel that has been sealed in plastic and placed in the freezer for about 15 minutes
  • an ice massage – exercise extreme caution with this method
  • a cold gel pack
  • a bag of frozen vegetables

Tips for Applying Cold

  • Apply cold immediately after injury or intense, high-impact exercise.
  • Always wrap ice packs in a towel before applying to an affected area.
  • It’s okay to repeatedly ice painful or swollen tissues. However, you should give your body a break between sessions.
  • Do not use ice in areas where you have circulation problems.
  • Never use ice for more than 20 minutes at a time.
  • It is helpful to elevate and compress the area, if possible.
  • Excessive use of cold can cause tissue damage.

Created October 25, 2014 | Category: Self Care