What’s the difference between Hot and Cold therapies?

Many people are confused as to which type of short term relief is beneficial to relive pain, and with good reason, as it very much depends on the type of injury.


If there has been a recent injury, then COLD is a good way to help reduce pain and swelling, e.g. ankle sprain or muscle strain. It helps to reduce inflammation by limiting the ability of the nerve to carry pain messages to the brain. It is important to use the cold on the site of inflammation, but it can sometimes be difficult to ascertain where this actually is. e.g. in the case of sciatic symptoms which present in the leg, the cause of the problem is the nerve root being compressed in the lower back or buttock muscles. In this case, COLD would best be applied to the lower back or buttock.


If you are suffering from generalised joint stiffness and muscle spasm, then HEAT can be very comforting and can help to relive symptoms. e.g. if the pain is largely in your back and not caused by a recent injury, then you may find heat to be beneficial as it causes all the surrounding muscles to relax, creating an initial sense of well-being. However, as you relax, you could potentially leave injured tissues more exposed to stress, and it is for this reason we suggest using HEAT for short periods.


If in doubt, always apply a cold pack first as it won’t do any harm. If it doesn’t work, then use heat.


Cold therapy: 

Ice and cold treatment is best applied within the first 48 hours after an injury. I recommend using a bag of frozen peas or a purpose-made ice pack wrapped in a tea-towel, as they are flexible enough to mould to the area of injury. If these are not available, then a plastic bag of ice cubes will also do the trick, albeit a little more uncomfortable. Another alternative is filling a sock with rice and placing it in the freezer. These are all easy to access and relatively cheap too! Just a quick side note, if you use a bag of frozen peas, please do not put them back in the fridge in hope of eating them with your dinner on another day!

Another temporary method is a sticky gel pack, which is applied directly onto the skin and stuck in place (be careful if you have any broken skin). These can be very useful to bring down a lump on a child’s forehead as they have the added bonus of not slipping off hard to reach places. There are also single use cold packs that just require crushing to be activated and stay cold for hours.

You can also use a gel filled pack, which can be either frozen or heated in water so it can be used for both hot and cold treatment. It might be a good idea to have two of these at home, one in the freezer when needed and the other ready to heat up. These are reusable, which makes them the most cost effective solution.

How long do I apply it for?

Limit the time of cold/ice application to no more than 15-20 minutes at a time. If the injury is very acute, this can be repeated every 90 minutes to 2 hours.


Heat therapy

Although the research is inconclusive regarding heat treatment, patients report a decrease in stiffness, improvement in flexibility and an overall sense of comfort when using heat. Who are we to negate positive patient outcomes, backed up by evidence or not?


A hot water bottle is the standard quick fix, but you can also use the hot gel pack above, or a wheat bag that can be heated in a microwave. There are also heated pads, like miniature electric blankets available from a pharmacy or large superstore.

How long do I apply it for?

I’d usually recommend about 15-20 minutes.

To conclude, I’d suggest trying the old-fashioned home options first before buying an expensive product. After all, if a bag of frozen peas doesn’t work any other kind of cold compress probably won’t either and if a hot water bottle is no help, a fancy electric pad won’t be either. However, if you find that heat or cold help relieve your pain for a while, there are some convenient alternatives to peas and hot water bottle. If you have any questions as to which is best for your own injuries or pain, please feel free to contact Michelle on 077594 84655 or zestosteopathy@gmail.com

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