Heat vs. cold therapy

“Should I ice it?” This is a question I get asked often when it comes to home care remedies for pain and muscle tension. To the surprise of many patients I often recommend heat over cold.

I think everyone has heard of the acronym R.I.C.E that stands for: Rest – Ice – Compress – Elevate. It is widely recognized as the essential first step in the treatment of acute injuries. When an individual experiences an acute injury like an ankle sprain or bicep strain that involves swelling, redness, and acute pain the correct choice of hydrotherapy is the application of cold and not heat.

Cold is typically applied until the heat signs of swelling and redness have dissipated, which is usually around 24 – 48 hours. Cold therapy has a constricting effect on local blood vessels; this makes it a very good choice of hydrotherapy when dealing with acute injuries. The blood constricting effects enable the reduction of swelling and redness from the injured area.

In contrast, heat therapy is used for chronic injuries, arthritis, muscle tension, muscle spasms and pain that do not involve swelling or redness. Waking up in the morning with a kink in your neck, or having your back go into spasm calls for the application of heat and not cold.

I want to clarify one point. Even though a sudden kink in the neck or a sudden back spasm often involves “acute” pain, the problem itself was likely not due to tissue damage such as a torn muscle. Chances are the problem was long in the making, caused by chronic muscle tension in the local area that led to a reduced blood and oxygen supply to those same muscles. Then one night of sleeping funny or one wrong awkward movement was enough to over load these tight and constricted muscles and send them into spasm and pain.

The application of heat is crucial for these situations! Heat encourages the blood vessels to enlarge and in turn improves the local blood and oxygen supply to the affected area, which helps to relax muscle tension and relieve pain and spasm.


Methods of Cold Therapy:

Cold therapy for acute injuries can come in many forms: bag of ice, frozen bag of peas, frozen magic bag, submerging the affected area in cold water. These are all good options. However, care should be taken with these options not to damage the skin with the cold temperatures. Ideally cold therapy is only applied to the area in a cycle of 10 minutes on and 10 minutes off.

While cold therapy is effective, what makes it effective can also be one of its biggest downfalls. Aside from the cold temperature affecting the skin, cold therapy as I mentioned earlier, reduces blood circulation, which is good for clearing swelling, but limits much needed fresh nutrient and oxygen rich blood from reaching the injured area. This can have an impact on recovery time. This is why in Chinese Medicine we use a neutral temperature herbal plaster called Yunnan Pai Yao instead of cold therapy for acute injuries.

Yunnan Pai Yao plasters are made from a combination of cold natured herbs and circulation stimulating herbs. The cold natured herbs work to stop swelling and redness just as cold therapy does, however with the addition of circulation stimulating herbs it prevents the clotting of blood in the injured area. This helps to prevent bruising, reduces pain and increases healing and recovery time by allowing fresh oxygen and nutrient rich blood to reach the injured area.


Methods of Heat Therapy:

Everyone loves heat therapy and it can be done in many forms. Hot showers, hot tub soak, hot water bottles, heating pads etc.  When using these types of heat therapies it is wise to do cycles of heat with 20 minutes on and 20 minutes off. If you do not have time for stationary heat therapy or you need heat therapy while at work, muscle balms such as tiger balm or muscle balm patches such as Gu Tong Tie Gao patches work great to offer on the go relief.


For any questions or to book an appointment please contact my office at (250) 860 2212 or visit my website www.kelownaacupunctureclinic.com 

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

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About the Author

Ryan Samuels is a Registered Acupuncturist and Chinese Medical Herbalist (R.Ac, R.TCMP) at KLO Chiropractic Centre in Kelowna. He holds a Doctor of Traditional Chinese Medicine diploma, and has a special interest in the treatment of digestive issues, neuropathy, acute & chronic pain, sports injuries, and migraines.  All treatments with Ryan are individualized and designed around your current physical and mental well being. 

Website link:  http://www.kelownaacupunctureclinic.com/

Contact Email:  [email protected] 

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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