when should I use hot and cold compresses?

Overview

Hot therapy, is also known as thermotherapy which use  heat in therapy, usually used for chronic pain. Cold therapy(Cryotherapy) is the immediate first aid particularly used in sports injuries.

Treating pain with hot and cold can be extremely effective for a number of different conditions and injuries, the complex part is knowing what situation calls for hot, and which calls for cold. Be aware, wrong therapy will make the symptom worse!

Below are some key points about cold and heat treatment. More detail is in the main article.

•  Cold treatment reduces swelling and inflammation by decreasing blood flow. Used for acute pain or injury. In general, apply compression cold within 48 hours after an injury. Apply heat therapy after 48 hours.
• Heat treatment promotes blood flow and helps muscles relax. Used for chronic pain.
• It’s a basic physics. Understand what’s going on and you will use each in the proper situation.

Heat therapy

How it works?
Heat therapy works by dilating the blood vessels, promote blood flow and circulation to a particular area due to increased temperature.
Improved circulation can help eliminate the buildup of lactic acid waste and decrease fatigue, enhance the dissipation and absorption of inflammation and promote the transport of oxygen and nutrients to tissue.
Heat therapy is effective at treating chronic muscle pain or sore joints caused by arthritis.

8 Types of hot therapy

• Reusable Heated gel packs

  Can be microwaved or heated in boiled water and tend to say warm for about 30 minutes. If you don’t like your hand being limited, you can buy the ice packs with hands-free wrap.

• Hot water bottle

  A rubber or soft plastic water bottle filled with hot water tends to stay warm for 20 to 30 minutes.

• Electric heating pad

  The advantage to electric heating pads is that they maintain a constant level of heat.

• Heated dry rice cotton bag

  Made with 100% cotton cloth so it can be microwaved safely. Fill the bag with dry white rice (not instant rice), put it into microwave for 3 minutes and provide about 20 minutes of warmth.

• Hot bath, hot tub or steam sauna

  These tactics use moist heat and tend to stimulate general feelings of comfort and relaxation.

• Car seat warmer

  If pain and stiffness are due to back or hip arthritis, using a car seat warmer can be an easy way to apply gentle heat to the spine and hips.

• Medications

  Such as rubs or patches containing capsicum.

• Infrared light therapy

  Emitting infrared radiant heat, it’s the same as the feeling of warmth from the sun on your skin and the heat from a heated gel pack.
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What is heat useful for?

• Heat is useful for relieving:
• Rheumatoid arthritis
• Pulled muscle
• Cramp
•  Chronic muscle pain
• Spasms & stiff relating to neck or back
• Nervous headache caused by stress, fatigue, spasms of neck
• Tendonitis, or chronic irritation and stiffness in the tendons.

When NOT to use

Heat should not be used if:

• The skin is hot, red or inflamed
• Viscera haemorrhage
• Bacterial conjunctivitis
• Eczema and allergic dermatitis
• Initial stage(2 days ) of soft tissue contusion, sprain or injury The person has dermatitis or an open wound
• The person may be insensitive to heat due to Diabetes or a similar condition such as Raynaud’s syndrome
• The person are very young or old, or have cognitive or communication difficulties.
• The facial risk triangle is infected with pyogenes
• Undiagnosed acute abdominal pain

Applying heat therapy

Time:15 – 20 minutes. No more than 20 minutes at a time, removing the heat for 10 minutes and reapplying it again

Potential risks of heat therapy

• Risk of burning your skin

  Heat therapy should utilize “warm” temperature （122 ^οF – 140 ^οF）instead of “hot” one. If you use heat that’s too hot, you may get an additional burn injury.

• Risk of infection spreading

  If you have an infection and use heat therapy, there is a chance that the heat therapy could increase the risk of the infection spreading.

• Risk of worsening the pain

  If heat therapy hasn’t helped lessen any pain or discomfort after a week, or the pain increases within a few days, you may choose the wrong treatment, see a doctor immediately, better to consult a doctor before applying hot or cold therapy.

Cold therapy

How it works？
Cold treatment reduces swelling and inflammation that causes pain, especially around a joint or a tendon by decreasing blood flow. It can temporarily reduce nerve activity, which can also relieve pain.

Some types of using cold therapy include

• Reusable cold packs ( filled with gel)

  Gel ice pack can be kept in the freezer ready for use when needed, and re-frozen after each use. Gel ice packs can mold to the contours of your body, which may provide better pain relief. If you don’t like your hand being limited, you can buy the ice packs on line.

Homemade cold packs

• Fill the sealable freezer bag.Pour a 2:1 mixture of water and rubbing alcohol into a  freezer bag until it is 3/4 full. (Dish soap, on its own, no water necessary or corn syrup are alternative ingredients). Freeze the package for 2-3 hours, it will develop into a gel pack due to the different freezing points of water and alcohol.

• Plastic baggie and ice. 

  Put the ice in a sealable plastic bag (baggie) and squeeze the air out of the bag before sealing it. You may want to add a little water to the ice so that the bag is not so lumpy.

• A frozen towel
  

  Place a folded, damp towel in a plastic bag and put it in the freezer for ten to twenty minutes. Then take the towel out of the bag and place it on the affected area.

• Wet Sponge

  Wet a sponge, wring it out partially, place it in a plastic baggie, and put in the freezer. After it is frozen, kept it in the baggie and applied to the sore joint or back.

• Rice
  

  Don’t like the wet? Try this way, create a reusable cold pack by filling a sock with rice and placing it in the freezer. Rice will get as cold as ice but does not melt when used.

• Frozen bag of peas

  If cold therapy is needed quickly, it is easy to grab a bag of frozen peas or other vegetables out of the freezer, place it in a baggie and apply it to the painful area.

• Instant ice packs (disposable ice packs)

  These packs can be “cracked” (typically by hand), make the pack to become cold in a matter of seconds by spurring a chemical reaction.

What is cold useful for?

Cold treatment can help in cases of:

• Acute tendonitis
• Acute arthritis
• Acute synovitis
• Migraine-pulsatile headache
• Strains and sprains
• Initial stage(2 days ) of sport injuryFor sport injury, you should follow the P.R.I.C.E. Principles

When not to use

Cold is NOT suitable if:

• Cramping, as cold can make this worse
• There is an open wound or blistered skin
• The person may be insensitive to heat due to Diabetes or a similar condition such as Raynaud’s syndrome
• Burn. Rinse or soak in running water for no less than 5 minutes instead of applying ice pack.
• Posterior occipital, ear, scrotum should not use cold to avoid frostbite

Applying cold therapy

Time:15 – 20 minutes. No more than 20 minutes at a time, removing the cold for 10 minutes and reapplying it again

Risks of cold therapy

• cold therapy applied for too long or too directly can result in skin, tissue, or nerve damage. Wrap the ice pack with thin towel or cloth when using.
• If you have cardiovascular or heart disease, consult your doctor before using cold therapy.

Summary

Knowing when to use cold therapy and when to use heat therapy will significantly increase the effectiveness of the treatment.

Use cold if the skin is hot, red or inflamed. Cold therapy is the immediate first aid for acute pain particularly used in sports injuries.

Heat is effective at treating chronic muscle pain or sore joints caused by Rheumatoid arthritis and relax spasms & stiff relating to neck or back.

Some situations will require both. Arthritic patients, for example, may use cold for swelling and acute pain and heat for joint stiffness
It’s also important to call your doctor for advice before applying hot or cold therapy.

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