When to use hot vs. cold therapy for pain relief

Nearly eight out of 10 adults experience lower back pain and one in three people suffer from neck pain at some point in their lifetime. The good news is there are ways to relieve lower back and neck pain with simple home remedies like hot and cold therapy.

“Both hot and cold temperatures can be effective at relieving pain depending on your lower back or neck pain symptoms,” says Dr. Edmund Fernandez, a family medicine physician at Aurora Health Care. Understanding when to use hot or cold therapy can increase the effectiveness of treatment.

Hot therapy

There are two kinds of hot therapy: dry heat and moist heat. Dry heat, or conducted heat, includes treatments such as heating pads, gel pads and saunas. Moist heat, or convection heat, includes treatments such as steam towels, moist heating packs and hot baths. “Typically, moist heat is slightly more effective at penetrating the tissue and providing results in less application time,” shares Dr. Fernandez.

“Hot therapy is useful in increasing circulation and blood flow to the area which soothes discomfort, relaxes your muscles and increases muscle flexibility” explains Dr. Fernandez.

Additional hot therapy tips

• Hot therapy works best for warming up your muscles before activity or morning stiffness.
• Hot therapy is typically more effective when applied for longer, unlike cold therapy which needs to be limited.
• Less severe pain, like minor stiffness or tension, can be relieved within only 15 to 20 minutes of hot therapy.
• If the area is bruised, swollen or has an open wound, hot treatment should not be applied.

Cold therapy

Cold therapy reduces the blood flow to the area, reducing swelling and discomfort. Also known as cryotherapy, it can be applied in several different ways. Common uses of cold therapy at home include ice packs, cold gel packs, coolant sprays and ice baths.

Cryostretching combines cold therapy and stretching to reduce muscles spasms. Cryokinetics involves using cold therapy before exercise to allow a person with an injury to perform an activity sooner than they may be able to otherwise.

Additional cold therapy tips

• Cold therapy is effective at temporarily reducing nerve sensitivity which can help lessen your pain.
• Cold treatments are most effective when applied as soon as possible after an injury.
• Cold therapy should be used for short time periods – typically 10 to 15 minutes, several times throughout the day.
• If the injury involves stiff joints or muscles, cold therapy should not be applied.

It is important to understand the potential risks associated with both hot and cold therapies as well. When using either treatment, anything applied directly to the skin should be wrapped in a towel or some sort of barrier. If the temperature of the treatment is too hot, it can burn the skin. On the other hand, if the treatment is too cold, it can cause skin, nerve or tissue damage.

At-home hot and cold therapy treatments should not be used if you have a sensory disorder that prevents you from feeling certain sensations. The lack of sensation may decrease your ability to feel if any damage is being done. If you develop bruising or skin changes during hot or cold treatment or cold therapy hasn’t improved the swelling of an injury within 48 hours, contact your doctor.

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