Hot and Cold Treatment: How to Make Pain and Injuries Feel Better

When you have a sore muscle or a bad strain or bruise, do you reach for the ice pack or plug in the heating pad? Should you heat the hurt, or use cold to cure?

Many of us don’t know the medical reasons for choosing whether to apply heat or cold to an injury or sore muscles. Often, our fall-back position is to simply choose what we are most comfortable with based on our personal preference and experience. If we hate being cold, we may automatically grab the hot water bottle.

Or conversely, if we tend to run hot, discomfort may send us to the freezer for our favorite ice pack. So how do we know which treatment is appropriate for which condition? And can we actually do damage if we choose incorrectly? A good rule of thumb is to remember "Ice for Injury" and "Heat for Hurt."

How Ice for Injury Helps

Applying cold to an injury is known as cryotherapy. The best time to reach behind the ice cream containers for an ice pack is immediately after an injury such as a sprained or pulled muscle or a bruise with swelling. If ice is applied in the first hours after such an injury, the healing time can be significantly shortened. Ice is a vasoconstrictor, meaning it narrows the capillaries or tiny blood vessels to lessen blood flow to an area. This means it will reduce inflammation at the site of the injury.

Inflammation can damage tissues and cause cell death in an injured area. If those effects are lessened at an early point of damage, healing time will be shortened. Studies have shown that a sprained ankle takes an average of three days less to heal if cold therapy is applied early on.

Ice is also a natural anesthetic. It numbs the area by significantly slowing pain messages sent from the site of the injury to the brain. Applying ice to an area that is red, swollen, or hot to the touch will immediately soothe and eventually numb the area, providing pain relief while aiding in lessening damaging inflammation.

Some ways that cold treatments are applied are with ice packs, cold compresses, gel wraps, and immersion in cold water. A make-shift cold compress can be made with something as simple as a bag of frozen peas, or ice cubes wrapped in a towel. Ice should not be applied directly to skin except in the case of ice massage, where an ice cube is gently rubbed in a circular motion over the injury and not left in place on the skin.

How Heat for Hurt Works

Applied Heat or thermotherapy is beneficial for chronic pain or discomfort. Unlike cold, heat should not be applied immediately after an injury. If swelling and redness is occurring after a strain or bruise, applying heat will worsen the inflammation. Heat is a vasodilator, meaning it opens tiny capillaries and allows for improved circulation and oxygenation of injured areas. Heat should be applied to relieve pain from sore muscles associated with exercise, and chronic conditions such as back and neck pain, or joint stiffness associated with arthritis.

Heat is especially beneficial to those who suffer from chronic back and neck pain. Not only does heat loosen and relax tight muscles, but it also offers relief and comfort for the stress and hyper-vigilance frequently experienced by those who suffer chronic pain in these areas.

Heat can be applied through electric heating pads, microwaveable gel packs, portable heat strips, and hot baths, or whirlpools.

When Should You Alternate Hot and Cold Treatments?

The practice of alternating hot and cold therapies is known as contrast therapy. Contrast therapy is helpful for bone fractures, tendonitis, plantar fasciitis, and arthritis of hands and fingers. Contrast therapy is often applied through alternating hot and cold baths in tubs or whirlpools. Contrast therapy results in the dilation and restriction of capillaries in rapid changes. These rapid changes create a pumping action in the blood vessels that promote healing.

You should seek medical advice and attention for both sudden and chronic injuries to muscles and joints, however, hot and cold treatments are great adjunct therapies that can be applied at home at little or no cost and can offer a great deal of relief, as well as promoting healing.

Resources— Medical News Today, WVUMedicine, PainScience.com

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