Overview
Therapeutic heating (thermotherapy) and icing (cryotherapy) can be an effective way of treating pain for a number of different conditions and injuries. It is cheap and easy to administer. However there is a lot of confusion on knowing when a situation calls for heat and when it calls for cold. Often a single treatment will even include both.
As a general rule ice is used for acute injuries to calm down damaged superficial tissues that are inflamed, red, hot and swollen and heat is used for muscles, chronic pain, arthritis and stress to ease symptoms like aching and stiffness.
Heat
How it works
Thermotherapy works by improving circulation and blood flow to a particular area. Increasing the temperature of the affected area causes the blood vessels to open wide (dilate). This brings more blood into the area which stimulates the healing of damaged tissues. This helps to ease discomfort, relax the muscles and relieve pain and spasm.
Types
There are two different types of thermotherapy: dry heat and moist heat. Both should aim for “warm” as the ideal temperature instead of “hot”. Dry heat includes sources like dry heat packs/pads and saunas. Moist heat includes sources like steamed towels, moist heat packs and hot baths. Professional heat therapy treatments can also be applied, for example heat from therapeutic ultrasound is often used to help patients suffering from tendonitis.
When using thermotherapy you can choose to use local methods (heat packs or hot water bottle) for small areas of pain, regional methods (heat wraps or steamed towels) for larger areas of pain or full body methods (saunas or hot baths) for widespread areas of pain/stiffness.
When not to use
There are certain cases where heat should not be used. If the area of pain or injury is either bruised, hot, red or swollen it is best to use ice. Heat should also never be applied to an area with an open wound. People with certain pre-existing conditions should also avoid heat due to a higher risk or burns or complications from the heat application. These include diabetes, deep vein thrombosis, vascular diseases and dermatitis. It is also best avoided after activity.
Application
Heat therapy should be not be used for an extended amount of time and you should never sleep with a heat treatment on. These common mistakes can lead to blisters, irritation and even burns. It is best to use heat for 15-20 minutes at a time with an hour gap in between each application. Ensure that the heat is at a comfortable temperature and if you start to experience any further discomfort remove the application.
Ice
How it works
Cryotherapy works by reducing blood flow to a particular area. Decreasing the temperature of the affected area causes the blood vessels to narrow (constrict). This reduces the inflammation and swelling around the area that causes pain.
Types
There are a number of different ways to apply ice therapy to an affected area. These include ice packs or frozen gel packs, coolant sprays, ice massages or ice baths.
When not to use
People with sensory disorders that prevent them from feeling certain sensations should not use cryotherapy at home because they may not be able to feel if damage is being done. This includes diabetes, which can result in nerve damage and lessened sensitivity. Icing should not be used on stiff muscles or joints and it is best avoided in people with poor circulation.
Application
When applying an ice pack ensure that it is always wrapped in a towel as if applied directly to the skin from the freezer it can cause damage to the skin and tissues. It should be applied as soon as possible following an injury. It is most effective when used for short periods of time (around 10-15 minutes) several times a day. It shouldn’t be applied for more than 20 minutes at a time as this can damage the skin and tissues.
Summary
Knowing when to use thermotherapy and cryotherapy will significantly increase the effectiveness of the treatment and in some situations it requires a combination of both. Arthritic patients, for example, may use heat for joint stiffness and ice for swelling and acute pain. If either treatment makes the pain or discomfort worse, stop it immediately and if the treatment hasn’t helped much with regular use in a few days or you want to speed up your recovery with some treatment give us a call!
If you are still unsure as to which treatment is best for your particular problem or you would like some further advice please call 020 3488 0585 or send us an email.