Hot or Cold? How best to treat your pain

Treating pain with hot or cold therapy can be extremely effective for a number of different conditions and injuries and is easily affordable.  The tricky part is knowing when to heat and when to ice.

As a general rule of thumb, it’s best to use ice for acute (new) pain such as a sprained ankle or pulled muscle.  You should use heat to ease achy muscles or for soothing stiff joints.

Heat therapy

Heat therapy works by improving circulation and blood flow to a particular area due to the increased temperature.  It can relax and soothe muscles that are in spasm, and help to heal damaged tissue.  A small area of pain can be treated with a warm heat wrap such as a wheat bag or hot water bottle.  Larger areas of pain can be treated with a warm bath.

If you add heat to a fresh injury, watch out: it’s going to get worse!

The golden rule is not to heat up anything that is already inflamed. The tell tale signs of inflammation are pain, redness, heat and swelling.  If you apply heat on top of inflammation your pain will get worse and your recovery time will lengthen.  You should use cold therapy for the first 48 – 72 hours to control the inflammation.

Heat therapy can be applied for a good amount of time, unlike cold therapy which needs to be limited.  Minor stiffness or tension can often be relieved with only 15 – 20 minutes of heat therapy.  Moderate to severe pain can benefit from longer sessions of heat such as a warm bath lasting for 30+ minutes.

Cold Therapy

Cold therapy works by reducing blood flow to a particular area.  This can significantly reduce the inflammation and swelling that causes pain, especially around a joint or a tendon.  It also acts as a temporary analgesic by reducing nerve activity.

There are a number of ways to apply cold therapy. Treatment options include:

  • Ice packs or frozen gel packs (frozen peas are a great alternative!)
  • Ice massage
  • Ice baths
  • Game Ready

You should not use cold therapy on stiff joints, and be especially wary of icing muscle pain. For instance, you may think your back is injured but it may “just” be muscle pain. Trigger points (painfully sensitive spots) can be surprisingly intense and easily mistaken for an “iceable”. But if you ice trigger points, they may ache even more acutely. This mistake is often made when treating lower back and neck pain — the very conditions people often try to treat with ice.

Applying cold therapy

Never apply a frozen item directly to the skin as it can cause damage to the skin and tissues. Apply an ice pack wrapped in a towel for 10 – 20 minutes.  You could also compress and elevate an affected limb to maximise results.

Game Ready

Game Ready is a state-of-the-art ice compression device that is often the most effective way of treating an acute muscle or joint injury. It significantly controls swelling and inflammation and is the injury treatment system of choice for thousands of Orthopaedic, Physiotherapist and Rehabilitation Clinics around the world.  Game Ready therapy is available at Haworth Physio and Sports Injury Clinic.