Pain Management: Hot vs. Cold Therapy

You’re in pain. Maybe you overdid your workout. Maybe you’ve suffered an injury. What can you do right away for relief? Hot, cold (and alternating therapies like massage) have long been used by sport medicine specialists to relieve pain and improve recovery. But which do you use? And when? Let us offer you this quick primer on hot and cold therapy for pain management.  

Cold Therapy 

When body tissues are injured or stressed they generally become inflamed, red, warm to the touch and painful. When you apply cold (through a variety of methods) swelling and bleeding are reduced because blood vessels constrict. This limits the movement of fluids into the affected area. Bruising is reduced as a result. Pain is reduced through numbing of the inflamed tissues.  

The time to use ice therapy is immediately after a sudden injury or muscle strain and within 48 hours of an occurrence like: 

  • Sprained ankle 

  • Muscle tear 

  • Bruise 

  • Inflammation 

In addition, cold treatment may be helpful for: 

  • Tendonitis 

  • Bursitis 

  • Tennis elbow 

  • Shin splints 

  • Plantar fasciitis 

Cold therapy is not recommended as effective for stiff muscles or joints. 

Types of Cold Therapy 

The age-old method of using a bag of frozen peas or corn applied to the affected area still works. A bag of ice is good too. Just be sure to wrap these items in a dry towel to protect your skin. There are also a number of convenient products available online and elsewhere specifically designed to provide cold treatment.  

You’ve probably heard of the effective RICE system: Rest, Ice, Compression, and Elevation.  

How to Use a Cold Compress 

Apply cold compression for 20 minutes every 4 to 6 hours. You can also soak the affected area in cold, but not freezing, water. Try massaging an ice cube or ice pack over the area for at most 5 minutes up to 5 times a day.  

Hot Therapy 

Stiff, sore muscles can greatly benefit from a hot therapy treatment. The heat helps to relax and loosen muscles and increase blood flow. Increased blood flow floods the affected area with oxygen and nutrients which contribute to the healing process.   

Just remember heat should not be used: 

  • To an area already warm to the touch 

  • On open wounds or blistered skin 

Heat can even be applied before working out to increase the elasticity of muscles and mobility of joints. Heat therapy is shown to be most helpful for conditions like: 

  • Muscle sprain or strain 

  • Osteoarthritis 

  • Muscle spasm 

  • Menstrual cramps 

 

Types of Heat Therapy 

There are a wide variety of ways to create heat therapy including: 

  • Hot water bottle 

  • Electric heating pad 

  • Microwaveable pad 

  • Heat wraps 

  • Paraffin wax treatment 

  • Warm bath 

  • Medications such as rubs and patches 

With heat therapy, you get relief due to the improved circulation, eliminating lactic acid waste that builds up after some forms of exercise. 

How to Properly Apply Heat for Injury 

A good rule of thumb is to apply heat for 20 minutes up to 3 times per day. Heat packs can be dry or moist. Dry packs can be applied for up to 8 hours. Moist packs act more quickly and can be applied for two hours.  

Can You Combine Hot and Cold Therapy?  

Sometimes great relief can be accomplished through a combination of hot and cold therapies for 3 to 5 days. It’s particularly helpful for muscle tears, overuse injuries and chronic joint pain.  

The dilation of blood vessels caused by heat combined with the constriction of blood vessels caused by cold creates an increase in the amount of nutrient-rich and oxygen-rich blood rushing to an injured or affected area. 

Of course, massage therapy can also help improve circulation and break up lactic acid. A massage can build on the benefits of hot or cold therapy. If you’re struggling with chronic pain, your Tampa Bay Sports & Medical Massage therapist can help you understand your best options for long-term pain management. Contact our top-rated massage center today! 

 

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