Cold or Heat – Which one should I choose?

Cold and heat therapies are common treatments to deal with pain, injuries and other conditions.

There are 2 questions we want to address today.

• When is it best to use them?
• How to apply them?

Cold Therapies

Cold therapies are typically used after an acute injury. In the presence of an acute injury, pain and inflammation is often present.

Examples of an acute injury are a muscle strain, ligament sprain, bone bruise or muscle contusion

To identify whether inflammation is involved, look for

• Redness
• Swelling
• Heat
• Tenderness

*If a combination of these symptoms are present, it is indicated to use cold therapy.

In a study by Hocutt et al, use of cold therapy that started within 36 hours of the injury was more effective than delayed cold therapy or heat therapy for faster and complete recovery of ankle sprains.

Typically, ice therapy is performed within the first 36 hours of the injury or continued for longer if inflammation persists.

How do to apply cold therapy

• Apply cold therapies to the affected area for a maximum of 15-20 minutes at a time, several times a day. Depending on the severity of the injury, you may need to increase the frequency of application in order to accelerate healing of the injured area.
• Do not apply cold therapies directly to the skin as it can damage skin, tissues and nerves in the affected area – wrap the cold object in a towel first prior to application.

Heat Therapies

Heat therapies are typically used for pain, relaxation of muscles, joint and muscle stiffness, reducing muscle spasms, prior to stretching a tight muscle area, and arthritis (if no inflammation is present).

Examples of conditions that can benefit include:

• Chronic Low back pain
• Chronic neck/shoulder muscle tension
• Arthritic joints

Typically, heat therapy is indicated to assist with recovery/relief as long as NO INFLAMMATION is present.

Types of Heat:

There are 2 types of heat that can be used to treat conditions. Depending on the condition, it may require a certain form of heat.

• Dry Heat: involves using a dry heat source which warms up the affected area superficially. Examples include dry heating packs, gel packs, electric heating pads.

• Moist heat: involves using a wet heat source which penetrates deeper into the body, reaching the muscles, joints, and ligaments. Examples include steamed towels, hot baths, moist heating packs

How to apply heat therapy

• Apply heat therapies to the affected area for a maximum of 15-30 minutes at a time, several times a day. Depending the severity of the injury, you may need to increase the frequency of application in order to accelerate healing of the injured area.
• Do not apply heat therapies directly to the skin as it can cause skin irritation or burns. Multiple layers of towels should be applied between the heat therapy and the skin.

When not to use heat or cold therapies:

While heat and cold therapies can be helpful for many individuals, for some it is advised not to use them.

Such individuals with conditions including:

• Lack of sensation in the skin
• Diabetes (if nerve damage and/or decreased skin sensitivity is present)
• Hypertension (high blood pressure)
• Impaired circulation
• Open/infected wounds
• Deep vein thrombosis

Cold and heat therapies are useful tools to assist with recovery from an injury or alleviate symptoms. If you find that the cold or heat therapies are not helpful enough with your symptoms, contact us to find out more about how we can help treat your symptoms.

References

Hocutt, J.E., Jr., et al., Cryotherapy in ankle sprains.Am J Sports Med, 1982. 10(5): p. 316-9.