Temperature therapy is highly useful in treating all sorts of pain, inflammation, and muscle stiffness, regardless of the cause. It is inexpensive and easy to use. Yet many people are unsure which situations call for ice, and which would be better treated with heat. As a general rule, ice is best for acute injuries, inflammation, and swelling, while heat works better for muscle stiffness or pain. Here are some more details.
Also known as cryotherapy, cold therapy works by reducing blood flow to the targeted area. This can reduce both swelling and inflammation, particularly around tendons and joints. It can also slightly numb the area, further reducing pain.
Cold therapy comes in many forms, from plain ice to frozen gel packs to cooling sprays. Some people even use a bag of frozen peas or other vegetables. Your physical therapist may also use cold therapy in tandem with stretching or active exercise, though this should never be attempted without professional supervision.
Never apply ice or any frozen item directly to the skin, as it could result in skin, tissue, or nerve damage. Always wrap the item in a towel to protect your body. Use cold therapy for no longer than .20 minutes at a time, although it is fine to reapply it several times throughout the day. Do not use cold therapy at home if you have any underlying condition that lessens your skin’s sensitivity, or if you have poor circulation. Talk to your doctor before using cold therapy if you have any cardiovascular diseases.
Cold therapy should not be used on stiff muscles. It works best when applied promptly after the injury or inflammation begins. If you see no noticeable signs of improvement after 48 hours, talk to your doctor.
While cold therapy reduces blood flow to the specified area, heat therapy increases it. This can ease pain, improve muscle flexibility, and heal damaged tissues. Note that heat therapy is a bit of a misnomer, as the goal is to gently warm the area, not to significantly heat it.
There are two types of heat therapy: dry and moist. Dry heat, such as that generated by a heating pad or sauna, is generally the easiest to apply at home. Moist heat, such as that generated by a steamed towel or hot bath, may be slightly more effective. In general, though, both can be used interchangeably. Your physical therapist may also apply specialized heat, such as through an ultrasound.
Heat therapy may be local, regional, or whole body. Local therapy targets one specific, small area, such as a sore calf muscle. A hot water bottle or small heating pad can deliver local heat therapy.
Regional therapy targets a greater portion of the body, such as the lower back. Large heating pads, heat wraps, and large steamed towels deliver excellent regional heat therapy.
Full body heat therapy may be indicated if you have pain or stiffness in several parts of your body, and it can be soothing even if only one area is experiencing discomfort. This is delivered by something that encompasses your entire body such as a hot bath or a sauna.
Do not use heat therapy if the afflicted area is bruised, swollen, or both, or if you have an open wound in the area. In addition, if you have an underlying condition such as diabetes, dermatitis, deep vein thrombosis, multiple sclerosis, or any vascular disease, you are at higher risk of complications from heat therapy. Ask your doctor before using heat therapy if you are pregnant or have high blood pressure or heart disease.
Unlike cold therapy, which must be strictly time limited, indirect heat therapy can generally be used for sessions as long as two hours, though minor pain or stiffness is often resolved in 20 minutes or less. Direct heat, especially at higher temperatures, should be applied for no more than 20 minutes at a time to reduce the risk for burns.
If swelling increases or you have any signs of infection, discontinue the use of heat therapy immediately and contact your doctor. Heat therapy could cause an infection to spread more rapidly. Also talk to your doctor if you do not experience relief from the pain within a week.
Ice and heat are both highly effective treatments that can be applied at home, but it is important to understand when to use which one. Of course, if either treatment makes you feel worse, stop using it immediately. Call your doctor if you develop any skin changes or worsening pain, or if you do not see results within a few days.
Founded by physical therapy innovator Dr. Joseph Simon, the Manhattan Physical Therapy and Pain Center is a leader in pain relief and injury recovery conveniently located in Midtown New York City. We offer several dedicated programs for different conditions, along with the latest innovations in physical therapy for all. If you are ready for the latest treatments for your pain or injury, we invite you to call us today at (212) 213-3480 to learn how we can help.