Eric Cerré, NMD | Take Back Your Life.

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Therapeutic Showdown: Hot Vs. Cold

Like many people, you probably have a bag of peas dating back to the 90s hanging out in your freezer that you use as a cold pack. Cold therapy is excellent for some injuries, and that bag of peas can come in handy. 

But have you ever reached into the freezer and wondered whether you should actually be using heat for your injury instead? Knowing whether to use hot or cold therapy for pain relief can be confusing. So, sit tight, and let’s run through the basics of hot and cold therapy!

Hot Therapy - How It Works and Its Benefits

Heat is magical, and so is your body. Using heat on your body causes the blood vessels to dilate, increasing blood flow to whatever area it touches. This increased blood flow helps deliver more oxygen and nutrients to the affected area, which can help reduce inflammation and promote healing. It also reduces muscle tension and promotes relaxation. And that’s always nice when you’re in pain!

There are two types of hot therapy: moist heat and dry heat. So which do you reach for and when?

A person should use moist heat on an injury to relieve pain, stiffness, or muscle spasms. Moist heat is effective immediately after exercise and can also be used 1-day post-exercise. It works best for chronic conditions and can be applied for a maximum of 10-15 minutes. 

Moist heat is particularly helpful for the inflammation of joints caused by arthritis. Examples of moist heat include moist heating packs, hot towels, or a soak in a tub or shower.

On the other hand, dry heat is suitable for alleviating muscle stiffness and increasing blood flow to the injured area. Dry heat can be applied immediately after exercise and 1-day post-exercise. Dry heat includes heating pads, hot water bottles, and infrared heating lamps.

Moist and dry heat should not be used on acute injuries or open wounds, as they can increase inflammation and delay healing.

Avoiding excessive heat is essential when using hot therapy, as this can cause burns or further damage to the affected area. It’s also important to avoid using heat therapy on swollen or inflamed body areas, as this can exacerbate the problem.

Cold Therapy - How It Works and Its Benefits

 Cold therapy can feel really good on an inflamed injury. Why? Applying cold to the body causes the blood vessels to constrict, which can help reduce swelling and inflammation. Cold therapy can also numb the affected area, which is great if you’re in a lot of pain.

There are several types of cold therapy, including ice packs, cold compresses, and cold baths. Ice packs are the most common form of cold therapy. They are typically used to reduce swelling and inflammation caused by injuries or surgeries. Cold compresses are similar to ice packs but are usually used for smaller body areas, such as the hands or feet. Cold baths are less common but can effectively relieve pain in larger body areas, such as the back or legs.

Avoiding excessive cold is essential when using cold therapy, as this can cause frostbite or further damage to the affected area. It’s also important to avoid using cold therapy on areas of the body that are numb or have poor circulation.

When to Use Hot Therapy and When to Use Cold Therapy

The decision to use hot or cold therapy depends on the type and severity of the pain. Hot treatment is generally best for chronic pain, such as arthritis, as it helps to relax the muscles and reduce inflammation. Cold therapy is best for acute pain, such as a sprained ankle or a pulled muscle, as it helps to reduce swelling and numb the affected area.

It’s also important to consider the stage of the injury or condition. For example, during the first 48 to 72 hours after an injury, cold therapy is typically recommended to reduce swelling and inflammation. After this initial period, heat therapy promotes healing and reduces muscle tension.

Combining Hot & Cold Therapy / Alternating Hot and Cold Therapy

In some cases, combining hot and cold therapy may relieve pain. Alternating hot and cold therapy can increase blood flow to the affected area, reduce inflammation, and promote healing. That’s a lot of benefits!

To use alternating hot and cold therapy:

  1. Start by applying heat to the affected area for 20 minutes.

  2. Switch to cold therapy for 20 minutes.

  3. Repeat this cycle several times, ending with cold therapy.

  4. Again, avoid excessive heat or cold, and always listen to your body to know if you’ve gone too far.

Summary

Knowing when to reach for hot or cold can be confusing. Remember, hot is generally used for chronic pain and cold for acute pain. Within the first 48-72 hours, practitioners recommend cold. After that, you reach for heat. Alternating between hot and cold when you have an injury is also advised, but just for 20 minutes at a time, and you should always end with cold. There you have it! 

If you’re experiencing muscle or joint pain or have a soft tissue injury that’s not healing, call Dr. Eric Cerré to see how he can help.