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When to Use Hot and Cold Therapy

Heat and cold are the two most common types of noninvasive and nonaddictive pain-relief therapies for muscle and joint pain. Which one you use depends on whether the pain is new or recurring.

In general, a new injury will cause inflammation and possibly swelling. Ice will decrease the blood flow to the injury, thereby decreasing inflammation and swelling. Pain that recurs can be treated with heat, which will bring blood to the area and promote healing.

The following information can help you learn when and how to use temperature-related therapies.

Heat therapy

What does heat therapy do?

Heat opens up blood vessels, which increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments, and tendons. The warmth also decreases muscle spasms and can increase range of motion. Applying superficial heat to your body can improve the flexibility of tendons and ligaments, reduce muscle spasms, and alleviate pain.

How is it applied?

Sources of heat can supply either dry or moist warmth. Dry heat sources may dry the skin. Moist heat may penetrate better. Heat can be applied by an electric or microwavable heating pad, hot water bottle, gel packs, or hot water baths. The heat should be warm, not too hot, and should be maintained at a consistent temperature, if possible. Ask your doctor or physical therapist which heat source would be best for you.

When do you use it?

Apply heat if you have stiff joints or chronic muscle and joint pain.

How can I use it safely?

Don’t apply it directly to skin. Instead, wrap the hot device in a thin towel.

Here are other tips:

  • Don’t apply heat for longer than 20 minutes, unless your doctor or physical therapist recommends longer.

  • Don’t use heat if there’s swelling. Use cold first, then heat.

  • Don’t use heat if you have poor circulation or diabetes.

  • Don’t use heat on an open wound or stitches.

  • Don’t lie down on a heating pad; you could fall asleep and burn your skin.

Cold therapy

What does cold therapy do?

Cold slows down blood flow to an injury, thereby reducing pain and swelling. Cold therapy slows circulation, reducing inflammation, muscle spasm, and pain. It should be used if the area is swollen or bruised.

How is it applied?

Cold is applied by an ice or gel pack.

When do you use it?

Any cold treatment should be used for 24 to 48 hours after an injury. Cold therapy is good for sprains, strains, bumps, and bruises that may occur in sports or lifting. Apply cold packs or ice bags to injured areas for no more than 20 minutes at a time, removing the cold for 10 minutes and reapplying it again.

How can I use it safely?

Don’t apply it for longer than 20 minutes. Also, wrap ice or ice packs in a thin towel before applying.

If in doubt as to whether to apply heat or cold to an injury, call your health care provider’s office.

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