Hot or Cold Treatment

Written by Victoria Bonin

Should I apply heat packs or cold packs? This is quite a common question, to answer it it’s interesting to understand the mechanism of both techniques. It all depends on the type of injury you suffer from. Some conditions require cold therapy whereas others will be improved with heat.

Both techniques involve a local change of temperature and induce physiologic responses. The body response is not the same whether you increase or decrease tissues’ temperature. This article will answer the following questions.

1. What are the effects of cold treatment?
2. How to apply cold?
3. What are the effects of hot packs?
4. How to apply heat packs?
5. What is the hot and cold treatment?
6. What are the effects of a hot and cold combination?
7. What are the contraindications of cold or hot therapy?

The body temperature is normally around 37.5 degrees. While applying cold on the skin, the temperature of the tissues decreases and causes:

Vasoconstriction, which is the reduction of the calibre of blood vessels. This helps to reduce the swelling.
Numbness nerve ending, helping to relieve the pain. This anaesthetic effect is local, and reversible in a few hours.

Cold therapy is known as an anti-inflammatory technique and is useful when you experience the following symptoms: pain, swelling, heat sensation and redness.

Cold therapy can be applied right after an injury, such as an ankle sprain. However, there are a few rules to respect to ensure you are using this therapy safely and usefully.

The most common technique is the use of a cold pack. Applying cold packs is a way to target a very specific area – a joint most of the time, suffering from inflammatory symptoms.

You can use cold packs up to 3 times a day, each application up to 20 minutes.
It is not recommended to keep the cold pack for more than 20 minutes as it will reduce the thermal shock and therefore decrease the benefits. A common mistake is to keep it for long hours, for example during the night.

Always make sure to use a tissue or a thin towel between the cold pack and your skin. This thin layer is essential to protect your skin from damage and a burning sensation. If you experience tinglings, or the skin is turning red, or pain, remove the ice pack immediately. After several days of application, make sure to check if your skin is not dry or cracked. If that’s the case, make sure to use a repairing and hydrating cream.

While applying a cold pack, make sure to sit or lay down in a comfortable position. A rubber band or a belt can be used to maintain the cold pack on the skin. To enhance the effects and reduce swelling, you can elevate the leg or arm while icing.

If you don’t have a cold pack, you could also use a bag of green peas or a bag filled with ice cubes. If you use a bag of peas, make sure to only use it for cold therapy and never eat it because you will break the cold chain. Mark it “unusable” with a label.

If you are looking for a more global technique, as an example to target both legs, you could try a cold shower or cold bath. Cold showers for legs are really helpful during summertime for people suffering from blood circulation issues.

If you use a massage gel, my advice would be to store it in the fridge, so you can benefit from a cold effect during the massage the next time you use the cream/gel.

Heat induces the opposite of cold treatment. Applying heat packs on the skin is causing local temperature rise. As body tissues are getting warmer, blood vessels widen, we call this process vasodilatation. The heat increases the calibre of blood vessels. A hot pack will locally improve blood circulation. The increase in blood flow will relieve the tension in the muscles and reduce the pain.
Heat packs are recommended on tense muscles and stiff areas of the body, but should not be used on a new and recent injury.

To apply heat, you can use either a hot-water bottle or microwavable heat packs. Ensure it is securely wrapped to prevent burning the skin.

Make sure to apply hot treatment for at least 15 minutes to have the benefits, and don’t go over 30 minutes of application.

The combination of both hot and cold treatments can be used in alternation to enhance the effects and benefits. This combination consists of alternating hot packs (2min) and cold packs (1min) on the same body part for 20 minutes. While doing this combination, you should always finish with a cold pack.

Through alternating both hot and cold therapy, a circulatory pump is created. Blood vessels will widen in response to the hot therapy and then narrow in response to cold therapy. This alternation of vasoconstriction and vasodilation creates a blood pump and improves blood flow and circulation.

Through this pump-like process, waste products such as toxins are more effectively removed from the body. This allows nutrient-rich blood to be provided to the injured area which enhances recovery.

When applying hot/cold packs, it is crucial to take certain precautions to ensure the safe use of hot/cold therapy. Before applying the hot/cold pack, always check its temperature to ensure it is not too hot/cold. You can do this by touching it lightly with the back of your hand or forearm. Additionally, never place the hot/cold pack directly on your skin, as it can cause burns. Be sure to securely wrap the hot pack with a cloth or towel before applying it to your body. This protective layer will help prevent any potential skin damage. By following these precautions, you can safely enjoy the benefits of heat therapy.

Although cold and hot therapies are great tools to use in most situations, there are a few exceptions and situations in which you must not use cold or hot therapy.

Avoid using if you suffer from heart disease, kidney problems, high blood pressure or diabetes.

Avoid using if the skin is injured, on an open wound, or if you suffer from an infection.

If you have any doubts or concerns about using hot or cold therapy, it is important to seek assistance from healthcare professionals such as doctors or physical therapists. They can provide personalized advice based on your specific condition and medical history, ensuring that you use these therapies safely and effectively.