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Heat pack Vs Cold pack: What should one use for various injuries?

September 12, 2023
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Whenever we encounter any pain or discomforts, injury or muscle soreness that one handy home remedy that we immediately and commonly use is hot or cold packs. But, most of us dwell with a dilemma of what to use when.  

Let’s look into the facts and evidence so as to have a better understanding on when to use hot and cold packs.  

Before looking into this, let us understand the physiological effects that hot or cold pack have on our body. This is important to know, because, it’s based on this, we would be choosing the appropriate method.  

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Heat therapy or hot packs expands joint and skin tissue temperature and escalates metabolism, increases blood circulation resulting vasodilatation, relaxes muscles through hindering gamma efferent nerve fibres and helps in reducing joint stiffness. Also, it causes analgesic effect

Cold pack or cryotherapy has the reverse effects to that of heat therapy. Cold helps in reducing the skin tissue and joint temperature thus decreasing the metabolic demand, at first reduces blood circulation causing vasoconstriction and a sudden release of blood flow or vasodilatation which is called as LEWIS HUNTING REACTION. This facilitates faster healing. Cold therapy also decreases inflammation, muscle spasm and provides analgesic effect.  

Hence, when to apply cold or hot depends on the effect it produces on the body. Let us look into various conditions of applications.  

  1. DOMS – Delayed onset of muscle soreness (DOMS) usually is describes as pain or discomfort of the muscle that occurs after performing any new physical activity or any activity with a sudden high intensity. This pain usually grows in the first 24-48 hours and remains until 72 hours post the activity and gradually lessens. In this case, hot packs are shown to be effective when used within 48 hours. The reason being the ability of the heat therapy to expand the skin tissue and joint temperature thus restricting heat loss and causing vasodilation and speeding up the metabolism for healing.
  2. Acute musculoskeletal injury like sprain/ strain of ligaments, joints, muscles- In the beginning it is advised to use ice in order to reduce swelling and inflammation. However, recent evidence support PEACE & LOVE injury management protocol by Blaise and Esculier in 2019 which does not recommend ice, instead advises on

             P- Protection

             E – Elevation  

             A- Avoiding anti-inflammatory drug

             C- Compression

             E- Education      

             L- Load

             O- Optimism

             V- Vascularization

             E- Exercise.  

However, if in any of this acute injury if swelling is noticed to be more, Icing can be applied. Simple sprains which does not involve much of swelling, icing is advised to be avoided.

       3. Chronic muscle pain or joint pain- In conditions like chronic neck pain, back pain or knee pain etc hot therapy is advised. Especially in conditions like rheumatoid            arthritis or any arthritis of joint.

       4.Joint stiffness or muscle tightness- In these conditions, heat therapy is advised as it makes better the tissue and joint flexibility, reducing the synovial fluid          viscosity and effects the tissues and connective tissue distention.  

       5. Menstrual pain - Menstrual pain is a outcome of uterine contraction. Heat therapy helps in relaxing the uterine muscle and the abdominal muscle when applied on lower abdomen. The effect of vasodilation supports in enhancing the blood flow to the pelvic region there by decreasing pain.

       6.Labour pain - During labour pain, it is advisable to go for heat therapy rather than cold therapy. Although, heat therapy is advised to be used over the lower back          and not directly over the lower abdominal muscles. The result of hot pack here is through blocking the nerves carrying pain signals built on pain gate theory.

Both hot and cold packs are usually used based on the pain condition. Therefore, it is always recommended to choose the treatment type based on the result it produces physiologically on the body and what is required during that particular painful condition.

Want to consult the Best Physiotherapists in India? Please find the links below.

  1. Best Physiotherapists in Mumbai
  2. Top Physiotherapists in Chennai
  3. Best Physiotherapists in Bangalore
  4. Top Physiotherapists near me in Pune
  5. Best Physiotherapists in Chandigarh
  6. Top Physiotherapists near me in Gurgaon
  7. Best Physiotherapists in Noida
  8. Best Physiotherapists in Panchkula
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