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Warm or Cold therapy options after an injury

Cold or warm therapy
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Whether you have been injured or if you suffer from chronic pains, it is important to know in which case you should use cold or hot patches, for the suppression of the pain.

Warm or Cold therapy?

Both patches can bring positive results when used properly but they may also cause greater damage when they are misused.
Below, you will find some basic principles regarding their proper use along with some differences in order to make the right choice after an injury.

A general rule is that we use cold patches in the case of acute pain while in chronic pains, we use warm patches.

Cold therapy

The normal body reaction after an injury is the creation of an inflammation or swelling. The blood vessels expand to carry more blood in the injured area in order to start the recovery procedure. Thus, using ice is a one way solution for the first 24-27 hours with the aim to:

  1. contract blood vessels
  2. reduce the inflammation and swelling
  3. reduce pain by assisting the irritated nerves of the area

The use of ice or an ice pack must be done carefully to avoid skin burns. The use of a towel between the cold patch is necessary and the total application time must not last over 20 minutes. Repeating after 2-3 hours is ideal and usually the use should last for 72 hours after the injury unless it is applied after having done an intensive training.

Warm therapy

On the other hand, warm therapy is more beneficial in chronic pains or conditions as it increases blood supply in the area and result in bigger oxygen and nutritious substances percentage which are carried there so as to make healing faster. Also, it can help tight or injured muscles relax.

Adverse results can be noticed if we use warm patches right after an injury occurs because the risk of an inflammation is higher due to the increase in temperature.
Theoretically speaking, warm therapy must be conducted 72 hours after the injury when the inflammation is supposed to be over.
The best way for warm therapy to be successful is to apply a warm, wet towel or to have a hot bath for about 10-30 minutes twice or 5 times a day.

  • Electrically heated pillows
  • Gel preparation which can be cooled or heated
  • An ordinary bag of ice or frozen vegetables (always wrapped in a towel)
  • Cold or warm compresses
  • A warm or cold bath
  • Do not exceed time and frequency of use during every day
  • Let the skin come back to its normal colour and temperature before repeating the procedure.
  • Check if your skin changes during the procedure (light redness of the area is acceptable)
  • If you notice any of the signs below, stop the procedure and call your doctor, because it means that the temperature was more than what your body can handle or that the application was more often than needed, so there might be a case of skin damage: blisters, rushes, intense itching, swelling, strong redness (blackish red or purplish red or appearance of red and white dots)
References:
1. http://westendchiromn.com/blog/should-i-use-heat-or-ice-after-an-acciden/
2. http://www.webmd.com/pain-management/try-heat-or-ice 
3. http://www.patient.co.uk/health/ice-and-heat-treatment-for-injuries

About the author

Lefteris Voulgaris

Physiotherapist

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