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  • Sharon Cole

Hot and Cold therapy for pain relief



Ice and heat are easy, natural and affordable ways to relieve pain. Despite the simplicity of heat and ice, the two (in the correct combination) can help ease lower back pain, muscle strains, and even arthritis. But first, let’s take a look at how and when to use them correctly.

As a cold person, I automatically apply heat to my lower back when I’m in pain, but is it always the right choice? Sometimes cold therapy using an ice pack is better for healing. The tricky part is knowing what situation calls for hot and which calls for cold, and sometimes treatment can include both.

In general, ice constricts the blood vessels, which numbs the pain, relieves inflammation and limits bruising, and should be used for acute injuries and pain. Heat, on the other hand, increases the blood flow, which relaxes tight muscles and relieves aching joints making it suitable for muscle pain and stiffness.

Heat therapy

Heat therapy works by improving circulation and blood flow to a particular area due to increased temperature. Even slightly raising the temperature to a painful area can soothe discomfort and increase muscle flexibility. Heat therapy can relax and soothe muscles and heal damaged tissue.

There are two different types of heat therapy: dry heat and moist heat. Both types of heat therapy should aim for “warm” as the ideal temperature instead of “hot.”

  • Dry heat includes sources like heating pads, dry heating packs, and even saunas. This heat is easy to apply.

  • Moist heat includes sources like steamed towels, moist heating packs, or hot baths. Moist heat may be slightly more effective as well as require less application time for the same results.

When applying heat therapy, you can choose to use local, regional, or whole-body treatment. Local therapy is best for small areas of pain, like one stiff muscle. You could use small heated gel packs, or a hot water bottle if you only want to treat an injury locally.

Regional treatment is best for more widespread pain or stiffness and heat can be applied with a steamed towel, large heating pad, or heat wraps. Full body treatment would include options like saunas or a hot bath.

When using heat therapy, be very careful to use a comfortable heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping.

Cold Therapy

Cold therapy works by reducing blood flow to a particular area, which can significantly reduce inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain.

There are many different ways to apply cold therapy to an affected area. Treatment options include:

  • ice packs or frozen gel packs

  • coolant sprays

  • ice massage

  • ice baths

You can make ice packs with ice cubes in a plastic bag or wet tea towel; a pack of frozen peas is also ideal and can go in and out of the freezer. Never place ice directly on an injury; keep the pack moving to avoid ice burns. Never treat with ice for more than 30 minutes, and remove the pack immediately if the injury appears bright pink or red.

Ice causes a longer-lasting effect on the circulation than heat. Also, the painkilling properties of ice are deeper and longer-lasting than heat.

Both heat and ice can be re-applied after an hour if needed.

Here is what the experts recommend for specific ailments;

Arthritis - worn away cartilage in the joints such as knee, shoulder, fingers etc. – Moist heat eases chronically stiff joints and relaxes tight muscles.

Gout flare-ups - Chronic inflammatory arthritis in the big toe, ankle, knee, wrist, finger etc. – Ice calms flare-ups and numbs the pain.

Headaches - pain from nerves or blood vessels in the head, or muscles in the neck - Ice numbs the throbbing head pain, whereas moist heat relaxes a painful neck spasm.

Strains - pulled a muscle or injured tendon in the thigh, back calf, etc. – ice eases the inflammation (redness, swelling and tenderness) and numbs the pain. Heat will then reduce the stiffness after the swelling has been taken care of.

SprainsStretching or tearing of ligaments in the joints like the knee, ankle, foot, elbow etc. – Ice eases inflammation and numbs the pain. Heat relieves stiffness after the swelling has been resolved.

Tendonitis Acute irritation after activity in tendons attached to the joints like the shoulder, elbow, heel etc. – Ice eases the inflammation and numbs the pain.

Precautions when using heat and ice

Do not use heat or cold packs: • Over areas of skin that are in poor condition. • Over areas of skin with reduced sensation to heat or cold. • Over areas of the body with known poor circulation. • If you have diabetes. • In the presence of infection.

Also, do not use ice packs on the left shoulder if you have a heart condition. Do not use ice packs around the front or side of the neck.

So, in conclusion;

Ice is for injuries – for calming down damaged and superficial tissue that is inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process but it tends to be incredibly painful too. Ice will act as a drugless way of dealing with this pain, reducing the swelling and inflammation.

Heat is for muscles, chronic pain and stress – relaxing muscles that are aching and stiff. Chronic pain, especially back pain, often involves lots of tension and stress, and heat can soothe both the muscles and the nervous system.

Sharon Cole

Hot stone massage

Free Download: How to make your own heat pack

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